Metyrapone

Sample type

Serum

Uses

1-to detect partial defects in pituitary ACTH secretion.

2-used in the diagnosis of certain problems of the adrenal glands.

3-used in both diagnosis and treatment of Cushing’s syndrome

Precautions

No special precaution required

Interferring factor

1-Adrenal tumor with excess cortisol production: no increase or fall in urinary 17-KS. The test is positive in 100% of patients with adrenal hyperplasias without tumor, 50% of those with adrenal adenomas, and 25% of those with adrenal carcinomas.

2-Ectopic ACTH syndrome: It may not be accurate in this condition.

3-Metyrapone administration may result in hypotension, nausea, and vomiting in patients with adrenal insufficiency; as a result, the 2- and 3-day tests should not be performed outside of the hospital in patients suspected of having this disorder.

4-Acute or chronic ingestion of synthetic glucocorticoids can result in a subnormal response as a result of suppression of the corticotropes.

Pre analytical erorr

carcinoma in adrenal gland andi ngestion of synthetic glucocorticoids affect the result

Corrective action

Taking medical history of patient

Post-analytical errors

1-Writing a wrong result or wrong name in the report

2-report were sent to incorrect patient

The corrective actions

1- If the report is not delivered to the patient and this error is discovered the correct result or the correct name must be written, but if the report is delivered to the patient must communicate with him and tell him that an error has occurred and replace with the correct report.

2-Communicate with patient ,apologizing for the error, and providing him with the correct report.