Salivary cortisol in the assessment of adrenocortical function in patients with pulmonary tuberculosis.
Chandra Immanuel; Raghupati Sarma, G.; Krishnamurthy, P.V.;
Geetha Ramachandran; Kumaraswami, V.
Indian Journal of Medical Research[A]; 1992; 95; 1-7.
Adrenocortical function was assessed on the basis of changes in salivary cortisol in patients with pulmonary tuberculosis and the findings compared with those in healthy subjects. A method of direct radioimmunoassay of salivary cortisol was standardized and the sensitivity was 0.8 nmol/l. Cortisol levels in saliva were significantly higher in the patients than in the healthy subjects (p < 0.001). The diurnal rhythm of cortisol secretion was distributed in the patients with a significant increase in salivary cortisol beyond 1800 h. While dexamethasone caused an appreciable suppression (87%), stimulation with ACTH (tetracosactrin) resulted in a marked increase in salivary cortisol, the increase being significantly higher in the healthy subjects than in the patients (p < 0.001). Attempts to classify subjects as positive or negative responders to tetracosactrin based on increases in salivary cortisol in relation to 'plasma cortisol' changes were however not successful, as the agreement between the two methods ranged from 73 to 80 per cent with various criteria used.
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