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I believe I was the one to post that information 3 years ago! To answer you directly, yes, in order to differentiate secondary versus early primary hypoadrenocorticism, I need to measure Haley's endogenous ACTH.
A normal or high endogenous ACTH concentration probably indicates early primary hypoadrenocorticism. In that case, treatment consists of prednisone and monitoring serum potassium and sodium; if or when mild hyperkalemia (increased serum potassium) occurs, the treatment regimen is changed to include both glucocorticoids and mineralocorticoids.
A low endogenous ACTH concentration indicates secondary hypoadrenocorticism. In that case treatment consists of prednisone.
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