A very low dose intravenous dexamethasone suppression test as an index of glucocorticoid sensitivity.
| Autor: | Faria CD; Pediatric Endocrinology Unit, Pediatric Department, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil., Cobra JF, Sousa E Silva T, Melo MR, Rocha MN, Hayashi LS, Faria TG, de Souza e Almeida JA, Kater CE, Longui CA |
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| Jazyk: | angličtina |
| Zdroj: | Hormone research [Horm Res] 2008; Vol. 69 (6), pp. 357-62. Date of Electronic Publication: 2008 Mar 17. |
| DOI: | 10.1159/000117392 |
| Abstrakt: | Background/aims: The wide variability of responses to corticotherapy suggests a role for individual recognition of steroid sensitivity in order to customize treatment. Oral dexamethasone (DEX) administration may be hindered by the rate of its intestinal absorption and the liver first-passage effect. In this study we suggest that an intravenous very low dose DEX suppression test (VLD IV-DST) can be used as an index for glucocorticoid (GC) sensitivity. Methods: We evaluated 87 normal subjects: 44 prepubertal children, 23 adolescents and 20 adults with a VLD IV-DST using 20 mug/m(2) of DEX (dose able to recognize GC sensitivity). Cortisol was initially measured at several time-points after DEX prompting us to establish its nadir and subsequent simplification of the test by measuring cortisol at baseline and after 120 min. Results: Baseline cortisol was similar in adolescents and in adults, but lower in children. There was a spectrum of individual responses in all age groups. The percent reduction of cortisol after 120 min was different in these three age groups, with median values of 44.4% in children, 25.9% in adolescents and 61.6% in adults. Conclusion: This simplified VLD IV-DST using 20 mug/m(2) of DEX is useful to evaluate individual sensitivity to GC in different age groups. ((c) 2008 S. Karger AG, Basel) |
| Databáze: | MEDLINE |
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