blood clothing system
Conditions
Interventions
Phase 1: We will first carry out a pilot study in which we will perform one
short ACTH stimulation test on 10 patients in light of routine laboratory
testing. Ten healthy volunteers will serve as co
Sponsors
Slotervaartziekenhuis
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Phase 1: Patients and healthy volunteers a. Adults >= 18 years old. b. Informed consent.;Phase 2. Cases a. Adults >= 18 years old. b. Informed consent. c. Primary adrenal insufficiency defined as: 1) Bilateral adrenalectomy 2) Auto-immuun adrenalitis 3) Congenital adrenal hypoplasia/ adrenal dysgenesis
Exclusion criteria
Exclusion criteria: Phase 1. a. Use of oral contraceptive agents, corticosteroids, anticoagulants, platelet aggregation inhibitors and NSAIDs. b. Known or suspected hypersensitivity to Synacthen; poorly controlled asthma; pregnancy and lactation; untreated acute or chronic bacterial, fungal and viral infections; diabetes mellitus type II; Cushing's syndrome; refractory congestive heart failure; active or latent peptic ulcer; acute psychosis; non-specific ulcerative colitis; diverticulitis; recent intestinal anastomosis; renal insufficiency (kreatinin > 200 umol/l); liver failure (ALAT, ASAT, yGT, AF > 3 times normal value); hypertension (systolic pressure above 140); myasthenia gravis or malignancy.;Phase 2. 1) Congenital adrenal hyperplasia (CAH) 2) Secondary adrenal insufficiency 3) Tertiary adrenal insufficiency 4) Primairy adrenal insufficiency induced by: a. Steroid synthesis inhibitors (e.g., metyrapone, ketoconazole, aminoglutethimide) b. Adrenolytic agents (o,p'DDD, suramin) c. Glucocorticoid antagonists (RU 486) d. Metastatic neoplasia/infiltration e. Criteria mentioned at phase 1 with the exception of corticosteroid use.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| • Coagulation activation markers F1+2 and ETP. If increased, the following will be tested: thrombin-antithrombin complexes (TAT), factor VII:C. • Endothelial cell activation and platelet activation markers von Willebrand factor antigen (vWf:Ag) and von Willebrand factor activity (vWf:RiCof). If increased, the following will be tested: thrombomodulin, P-selectin. • Clotting factor VIII activity (fVIII:C). • Fibrinolysis activation markers: plasmin-antiplasmin complexes (PAP) and D-dimer. If increased, the following will be tested: tissue-type Plasminogen Activator (t-PA), urokinase-type plasminogen activator (u-PA), Plasminogen Activator Inhibitor-1 (PAI-1) activity and antigen. • Blood coagulation time: PT, aPTT. | — |
Countries
Netherlands
Outcome results
None listed