Vol. 7 (03) pp. 115-119 DOI: 10.21474/IJAR01/8608

PREDICTIVE FACTORS OF BIOLOGICAL ADRENAL INSUFFICIENCY AFTER A LONG-TERM GLUCOCORTICOID THERAPY.

, , , ,
  • Department of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Marrakech, Marrakech, Morocco.
9 Downloads 103 Views
Crossref

Download Full Paper (PDF)

Abstract

Purpose:The predictive factors of adrenal insufficiency after a prolonged, continuous course of corticosteroids is poorly documented. We evaluated it retrospectively in our department of endocrinology. Methods:The patients were included between January 2015 to January 2017 and were administered a Synacthene? 250 ug test (ST250) after substitution with hydrocortisone for at least 4 to 6 weeks. A non-responsive test was defined by a cortisol increase below 21ug/dL, 60 min after stimulation. We studied the risk factors associated with biological adrenal insufficiency by SPSS analysis. Results:sixty seven patients were included (mean age: 42 ? 13,10 years). Mean initial dose of corticosteroids was 41,95 ? 34,16 mg/d. forty-three patients failed to respond to the ST250. The comparison between the responder group and the non-responder group at TS250 showed that the difference is significant for the basal cortisol level (p= 0,016) and for the duration of the CTC (p=0.045). Conclusion:Biological adrenal insufficiency is very common after a prolonged course of corticosteroids. Hence, clinicians should be vigilant for adrenal insufficiency at all degrees of glucocorticoid exposure.

Keywords

How to Cite This Article

Fatima Zahra El Bouazzaoui, Bahia Habra, Sana Rafi, Ghizlane El Mghari, Nawal El Ansari. (2019); PREDICTIVE FACTORS OF BIOLOGICAL ADRENAL INSUFFICIENCY AFTER A LONG-TERM GLUCOCORTICOID THERAPY., International Journal of Advanced Research (IJAR), 7 (03), 115-119, ISSN 2320-5407. DOI: https://doi.org/10.21474/IJAR01/8608

Corresponding Author

FATIMA ZAHRA EL BOUAZZAOUI
Department of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Marrakech, Marrakech, Morocco

Article Analytics

References

  1. Sprague RG. et al. (1950) : Physiological effects of cortisone and pituitary adrenocorticotropic hormone (ACTH) in man. J Am Med Assoc, 144(16) :1341?7.
  2. Fraser CG. et al. (1952): Adrenal atrophy and irreversible shock associated with cortisone therapy. J Am Med Assoc, 149(17) :1542?3.
  3. Salassa RM. et al.(1953) : Postoperative adrenal cortical insufficiency: occurrence inpatients previously treated with cortisone. J Am Med Assoc, 152(16):1509?15.
  4. Salvatori R. (2005)?: Adrenal insufficiency?.JAMA, 294(19) : 2481?8.
  5. Chaieb L. et al. (1984)?: Le test rapide ? la 1-24 corticotrophinedansl?axecorticotrope. Presse Med, 13: 2183?7.
  6. Sampson PA. et al. (1962) : Adrenal function in surgical patients after steroid therapy. Lancet, 1: 322?5.
  7. Livanou T. et al. (1967): Recovery of hypothalamic-pituitary adrenocortical function after corticosteroid therapy. Lancet, 2(7521): 856?9.
  8. Wood JB. et al. (1965) : rapid test of adrenocortical function. Lancet, 1(7379): 243?5.
  9. Schalaghecke R. et al. (1992): The effect of longterm glucocorticoid therapy on pituitary-adrenal responses to exogenous corticotropin-releasing hormone. N Engl J Med, 326(4): 226?30.
  10. Rebecca M. et al. (2016): Systemic glucocorticoid therapy and adrenal insufficiency in adults: A systematic review Seminars in Arthritis and Rheumatism, 46 (1): 133?141.
  11. Goichot B. et al. (2007)?:Quereste-t-il de l?insuffisancesurr?nale post-corticoth?rapie ? Presse Med, 36(7) :1065?71.
  12. Cunningham SK, et al. (1983): Normal cortisol response to corticotrophin in patients with secondary adrenal failure. Arch Intern Med,143(12): 2276-2279.
  13. Oelkers W. (1998) : The role of high- and low-dose corticotrophin tests in the diagnosis of secondary adrenal insufficiency. Eur J Endocrinol, 139(6) : 567-570.
  14. Pugneta, G. et al. (2010): Frequency and factors associated with biological adrenal insufficiency screened by the 250 ugcorticotropin stimulation test after a prolonged course of systemic glucocorticoid therapy. A study of 100 patients. La Revue de m?decine interne, 31: 332?336
  15. Oliver C. et al. (1998) : Choice of diagnostic tests for adrenal cortex insufficiency. Ann Endocrinol, 59 : 31?3.
  16. Desram? J. et al. (2002)?: Assessment of hypothalamic-pituitary-adrenal axis function after corticosteroid therapy in inflammatory bowel disease. Am J Gastroenterol, 97:1785?91.
  17. Aubert H, Kuhn JM. (1990)?:Cons?quencesendocriniennes de la corticoth?rapie. Le sevraged?unecorticoth?rapie au long cours. Rev Prat, 40:544?8.
  18. Bertherat J (2002). Corticoth?rapieetfonctionsurr?nalienne. Encycl Med Chir.

Similar Articles

Creative Commons Attribution 4.0 This work is licensed under a Creative Commons Attribution 4.0 International License.