adrenocorticotropic hormone (ACTH) stimulation test with metyrapone, a blood or urine test similar to the ACTH stimulation test with cosyntropin. The test can confirm adrenal hyperplasia or adrenal adenoma or carcinoma. It can document that adrenal insufficiency exists as a result of pituitary disease rather than primary adrenal pathology. Metyrapone has been associated with life-threatening adrenal crisis in patients with primary insufficiency and should not be used on such patients.
