====== Corticotropin-releasing hormone stimulation test ======

The [[corticotropin-releasing hormone]] (CRH) stimulation test has been used as a diagnostic test in both [[adrenal insufficiency]] and [[Cushing syndrome]]. In 95% of normal subjects, baseline ACTH increases two- to fourfold within 30-60 minutes of CRH administration
((Grinspoon SK, Biller BM. Clinical review 62: Laboratory assessment of adrenal insufficiency. J Clin Endocrinol Metab. 1994 Oct; 79(4):923-931.))
((Perry LA, Grossman AB. The role of the laboratory in the diagnosis of Cushing's syndrome. Ann Clin Biochem. 1997 Jul; 34(Pt 4):345-359. PubMed 9247665))
((Nieman LK, Oldfield EH, Wesley R, Chrousos GP, Loriaux DL, Cutler GB Jr. A simplified morning ovine corticotropin-releasing hormone stimulation test for the differential diagnosis of adrenocorticotropin-dependent Cushing's syndrome. J Clin Endocrinol Metab. 1993 Nov; 77(5):1308-1312.))
((Trainer PJ, Faria M, Newell-Price J, et al. A comparison of the effects of human and ovine corticotropin-releasing hormone on the pituitary-adrenal axis. J Clin Endocrinol Metab. 1995 Feb; 80(2):412-417.)).

The [[corticotropin-releasing hormone]] (CRH) stimulation test is a second-line non-invasive dynamic test for precise localization of disease in which at least a 35-50% increase of [[ACTH]] and 20% increase of [[cortisol]] concentrations from baseline indicate the [[pituitary gland]] as the origin of [[hypercortisolemia]]
((Invitti C, Pecori Giraldi F, de Martin M, Cavagnini F, Study Group of the Italian Society of Endocrinology on the Pathophysiology of the Hypothalamic-Pituitary-Adrenal Axis Diagnosis and management of Cushing’s syndrome: results of an Italian multicentre study. J Clin Endocrinol Metab. 1999;84(2):440–448.))
((Nieman LK, Oldfield EH, Wesley R, Chrousos GP, Loriaux DL, Cutler GB., Jr A simplified morning ovine corticotropin-releasing hormone stimulation test for the differential diagnosis of adrenocorticotropin-dependent Cushing’s syndrome. J Clin Endocrinol Metab. 1993;77(5):1308–1312.))
((Reimondo G, Paccotti P, Minetto M, Termine A, Stura G, Bergui M, Angeli A, Terzolo M. The corticotrophin-releasing hormone test is the most reliable noninvasive method to differentiate pituitary from ectopic ACTH secretion in Cushing’s syndrome. Clin Endocrinol (Oxf) 2003;58(6):718–724.)).