TY - JOUR T1 - Retrospective review of Synacthen testing in infants JF - Archives of Disease in Childhood JO - Arch Dis Child DO - 10.1136/archdischild-2017-313819 SP - archdischild-2017-313819 AU - Timothy Shao Ern Tan AU - Claire Manfredonia AU - Rakesh Kumar AU - Julie Jones AU - Elaine O’Shea AU - Raja Padidela AU - Mars Skae AU - Sarah Ehtisham AU - Fiona Ivison AU - Lesley Tetlow AU - Peter E Clayton AU - Indraneel Banerjee AU - Leena Patel Y1 - 2018/01/11 UR - http://adc.bmj.com/content/early/2018/01/11/archdischild-2017-313819.abstract N2 - Background A subnormal cortisol response (30 min level (C30min)<550 nmol/L) to synthetic adrenocorticotrophic hormone/Synacthen test (SDST) in all infants does not necessarily indicate underlying or persistent hypothalamic–pituitary–adrenal axis pathology.Methods We retrospectively evaluated the diagnoses and outcomes in 68 infants who had a SDST at age <6 months from 2011 to 2014.Results 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 0.1–3.2) 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 C30min (390 nmol/L vs 181 nmol/L, P=0.01) than those with pathology.Conclusion 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. ER -