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Treatment algorithm of ACTH deficiency
- Source :
- The Journal of Medical Investigation. 69:287-293
- Publication Year :
- 2022
- Publisher :
- University of Tokushima Faculty of Medicine, 2022.
-
Abstract
- Objective : To examine diagnostic performance of corticotropin-releasing hormone (CRH) test combined with baseline dehydroepiandrosterone sulfate (DHEA-S) in patients with a suspect of central adrenal insufficiency. Methods : Patients (n=215) requiring daily or intermittent hydrocortisone replacement, or no replacement were retrospectively checked with their peak cortisol after CRH test and baseline DHEA-S. Results : None of 106 patients with the peak cortisol ≥ 17.5 µg / dL after CRH test required replacement, and all 64 patients with the peak cortisol 10.0 µg / dL required daily replacement. Among 8 patients with 10.0 µg / dL ≤ the peak cortisol 17.5 µg / dL and baseline DHEA-S below the reference range, 6 patients required daily replacement and 1 patient was under intermittent replacement. Among 37 patients with 10.0 µg / dL ≤ the peak cortisol 17.5 µg / dL and baseline DHEA-S within the reference range, 10 and 6 patients were under intermittent and daily replacement, respectively. Conclusions : No patients with the peak cortisol ≥ 17.5 µg / dL required hydrocortisone replacement, and all patients with the peak cortisol below 10.0 µg / dL required daily replacement. Careful clinical evaluation was required to determine requirement for replacement in patients with 10.0 µg / dL ≤ the peak cortisol 17.5 µg / dL even in combination with baseline DHEA-S. J. Med. Invest. 69 : 287-293, August, 2022.
- Subjects :
- Hydrocortisone
Corticotropin-Releasing Hormone
Dehydroepiandrosterone Sulfate
General Medicine
treatment algorithm
General Biochemistry, Genetics and Molecular Biology
dehydroepiandrosterone-sulfate (DHEA-S)
Adrenocorticotropic Hormone
central adrenal insufficiency
Humans
Algorithms
corticotropin-releasing hormone (CRH) test
retrospective cohort study
Adrenal Insufficiency
Retrospective Studies
Subjects
Details
- ISSN :
- 13496867 and 13431420
- Volume :
- 69
- Database :
- OpenAIRE
- Journal :
- The Journal of Medical Investigation
- Accession number :
- edsair.doi.dedup.....2901f384dfb7fff786b5276f3eb0bf38