Treatment algorithm of ACTH deficiency

Autor: Yukari, Mitsui, Yuto, Iizuka, Tomoaki, Tanaka, Tomoyo, Hara, Shiho, Masuda, Yukiyo, Ohnishi, Mai, Kanai, Kiyoe, Kurahashi, Sumiko, Yoshida, Takeshi, Kondo, Toshiko, Kanezaki, Yasumi, Shintani, Hiroki, Yamagami, Yuki, Yamaguchi, Yuichi, Fujinaka, Kana, Morimoto, Atsuhisa, Shirakami, Ken-Ichi, Aihara, Seiji, Fukumoto, Masahiro, Abe, Itsuro, Endo
Rok vydání: 2022
Předmět:
Zdroj: The Journal of Medical Investigation. 69:287-293
ISSN: 1349-6867
1343-1420
Popis: 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.
Databáze: OpenAIRE
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