Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 217.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26835424
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Eur+Thyroid+J
2015 ; 4
(4
): 222-5
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Methylprednisolone Pulse Treatment of Graves Ophthalmopathy Is Not Associated
with Secondary Adrenocortical Insufficiency
#MMPMID26835424
Jespersen S
; Nygaard B
; Kristensen LØ
Eur Thyroid J
2015[Dec]; 4
(4
): 222-5
PMID26835424
show ga
OBJECTIVE: Graves' ophthalmopathy (GO) is an inflammatory disease in the orbital
region. The first-line medical treatment is glucocorticoids. An important
potential side effect of glucocorticoid treatment is suppression of the
hypothalamic-pituitary-adrenal (HPA) axis with impairment of endogenous cortisol
production, implicating symptoms of adrenocortical insufficiency, especially in
the period after cessation of therapy with possible risks in cases of
intercurrent illness. The aim of this study was to evaluate HPA axis function
before and after methylprednisolone pulse treatment of GO. STUDY DESIGN: HPA axis
function was evaluated by measurements of plasma ACTH and an ACTH stimulation
test with plasma cortisol measurements at 0 and 30 min after an intravenous bolus
of synthetic ACTH (Synacthen® 250 µg). This was done in 12 patients with GO
before and at cessation of methylprednisolone pulse treatment (500 mg i.v. per
week for 6 weeks followed by 250 mg i.v. per week for an additional 6 weeks).
RESULTS: All patients included fulfilled the criteria of intact HPA axis function
before and at cessation of methylprednisolone pulse treatment. Data are given as
medians (with ranges). Before glucocorticoid treatment basal plasma cortisol was
290 nM (196-579) and 786 nM (612-1,050) after ACTH stimulation. At cessation of
therapy the corresponding values were 309 nM (88-718) and 852 nM (524-1,011),
respectively. Thus, all patients passed a 30-min stimulated plasma cortisol of
500 nM. Before treatment plasma ACTH was 4.2 pmol/l (4-16) and at cessation of
therapy the corresponding value was 4.8 pmol/l (2-9; p = 0.27). CONCLUSION:
Transient suppression of the HPA axis with secondary adrenocortical insufficiency
does not seem to be a common phenomenon after intravenous methylprednisolone
pulse therapy for GO. Therefore, routine precautions are not necessary. However,
our results do not exclude that transient secondary adrenocortical insufficiency
might occur occasionally.
free
free
free
