CRHstimulaatiosta

CRHstimulaatio, also known as the corticotropin-releasing hormone stimulation test, is a diagnostic procedure used to assess the function of the hypothalamic-pituitary-adrenal (HPA) axis. This axis plays a crucial role in the body's stress response and regulates the production of cortisol. The test involves administering corticotropin-releasing hormone (CRH) intravenously and then measuring the levels of adrenocorticotropic hormone (ACTH) and cortisol in the blood at specific intervals.

The primary indication for a CRH stimulation test is the investigation of suspected adrenal insufficiency, particularly Cushing's disease or secondary/tertiary adrenal insufficiency. In Cushing's disease, an overproduction of ACTH by the pituitary gland leads to excessive cortisol secretion. The CRH test can help differentiate between pituitary-dependent Cushing's disease and other causes of hypercortisolism, such as adrenal tumors or ectopic ACTH production. For suspected adrenal insufficiency, the test can help determine if the pituitary gland is capable of releasing ACTH in response to CRH stimulation.

The procedure typically involves fasting overnight. CRH is injected, and blood samples are drawn at baseline and at various time points afterward, usually 15, 30, 60, 90, and 120 minutes. The interpretation of the results depends on the measured levels of ACTH and cortisol. Abnormal responses can indicate issues at the pituitary level, the adrenal gland level, or a combination thereof, aiding clinicians in making a diagnosis and formulating an appropriate treatment plan.