{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T02:46:30Z","timestamp":1775097990136,"version":"3.50.1"},"reference-count":5,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A subnormal cortisol response (30\u2009min level (C<jats:sup>30min<\/jats:sup>)&lt;550\u2009nmol\/L) to synthetic adrenocorticotrophic hormone\/Synacthen test (SDST) in all infants does not necessarily indicate underlying or persistent hypothalamic\u2013pituitary\u2013adrenal axis pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated the diagnoses and outcomes in 68 infants who had a SDST at age &lt;6 months from 2011 to 2014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>29 (43%) infants had a subnormal SDST. Causative pathology was identified in 9\/29 (31%). In 20\/29 (69%) with no identified pathology, repeat SDST was normal in 18\/20 (90%) at median age 0.6 (range 0.1\u20133.2) years but persistently subnormal in 2. Those with a transient abnormality were more likely to be small for gestational age (P=0.03) and had higher initial SDST C<jats:sup>30min<\/jats:sup> (390\u2009nmol\/L vs 181\u2009nmol\/L, P=0.01) than those with pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Specific aetiology can be identified in a third of infants with a subnormal SDST. When the aetiology remains elusive, adrenal function should be reassessed as the problem can be transient.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2017-313819","type":"journal-article","created":{"date-parts":[[2018,1,12]],"date-time":"2018-01-12T13:25:23Z","timestamp":1515763523000},"page":"984-986","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Retrospective review of Synacthen testing in infants"],"prefix":"10.1136","volume":"103","author":[{"given":"Timothy Shao Ern","family":"Tan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Manfredonia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0039-2142","authenticated-orcid":false,"given":"Rakesh","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine","family":"O\u2019Shea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja","family":"Padidela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mars","family":"Skae","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Ehtisham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Ivison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesley","family":"Tetlow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter E","family":"Clayton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indraneel","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leena","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,12]]},"reference":[{"key":"2020050712425442000_103.10.984.1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-311289"},{"key":"2020050712425442000_103.10.984.2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12039"},{"key":"2020050712425442000_103.10.984.3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2001-011620"},{"key":"2020050712425442000_103.10.984.4","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2009.24"},{"key":"2020050712425442000_103.10.984.5","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/MED.0b013e32833363cc","article-title":"Transient adrenal insufficiency in the premature newborn","volume":"17","author":"Quintos","year":"2010","journal-title":"Curr Opin Endocrinol Diabetes Obes"}],"container-title":["Archives of Disease in Childhood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2017-313819","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T22:10:28Z","timestamp":1601071828000},"score":1,"resource":{"primary":{"URL":"https:\/\/adc.bmj.com\/lookup\/doi\/10.1136\/archdischild-2017-313819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,12]]},"references-count":5,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2018,9,19]]},"published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1136\/archdischild-2017-313819"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2017-313819","relation":{},"ISSN":["0003-9888","1468-2044"],"issn-type":[{"value":"0003-9888","type":"print"},{"value":"1468-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,12]]}}}