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An update on the biochemical diagnosis of congenital ACTH insufficiency

Objective  Congenital ACTH insufficiency due to disorders of the hypothalamo–pituitary axis is life threatening. However, the optimal method for establishing the diagnosis remains controversial. The standard Synacthen test (SST) is safe and easy to perform in infancy, but its performance has not been well evaluated in infants and children with ACTH insufficiency.