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How to interpret a single cortisol measurement
  1. Meera Shaunak1,
  2. Joanne C Blair2,
  3. Justin Huw Davies1
  1. 1 Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2 Department of Endocrinology, Alder Hey Childrens NHS Foundation Trust, Liverpool, UK
  1. Correspondence to Dr Justin Huw Davies, Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, Southampton, UK; justin.davies{at}


Adrenal insufficiency can present with non-specific clinical features. Therefore, a single cortisol measurement is often included in the biochemical work-up of an unwell child. This article aims to review the diagnostic utility of a single cortisol measurement by outlining the physiological, clinical and technical factors affecting result interpretation. Clinical scenarios are used to illustrate how this test may be used in different commonly encountered situations in general paediatrics, with the aim of minimising the frequency of inconclusive results.

  • endocrinology
  • general paediatrics

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  • Correction notice This article has been updated to an Interpretations paper since it was first published online.

  • Contributors MS drafted the initial manuscript and revised the manuscript. JHD and JCB reviewed and revised the manuscript. All authors approved the final manuscript as submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement Data sharing not applicable as no datasets were generated and/or analysed for this study. No data are available. No data included.