| Popis: |
DEXAMETHASONE, a potent synthetic analog of hydrocortisone, was introduced in 1958 for treatment of rheumatoid arthritis. A satisfactory antirheumatic response usually requires treatment with a dose that is commonly associated with side effects.1We recently observed a patient with rheumatoid arthritis in whom 0.75 mg of dexamethasone daily for two months resulted in Cushing syndrome. We thought that this dose was approximately equal in glucocorticoid potency to the amount of cortisol secreted daily by the adrenal cortex. Endogenous Cushing syndrome was considered initially but was excluded. We studied the patient's metabolism of dexamethasone in an attempt to explain the phenomenon. Methods All studies were performed in the Clinical Research Center. Written consent was obtained from the patient after the nature of the procedure was explained. Our normal values and methods for measuring plasma cortisol, plasma 11-deoxycortisol, and dexamethasone have been described in detail previously.2-4The coefficient of variation |
