Pituitary-adrenal function following dexamethasone-cyclophosphamide pulse therapy for pemphigus

The British Journal of Dermatology
L KumrahJ S Pasricha

Abstract

Systemic corticosteroid therapy is known to lead to pituitary-adrenal (PA) suppression. Although patients treated for pemphigus with dexamethasone-cyclophosphamide pulse (DCP) therapy have shown no evidence of PA suppression, no study has been conducted to study this possible side-effect of DCP therapy. To study the effect of DCP therapy for pemphigus on PA function. A cross-sectional study was carried out in 33 patients who completed phase II of DCP therapy in a single centre, a large teaching hospital in New Delhi, India. Serum cortisol levels following adrenocorticotrophic hormone stimulation were analysed in 31 patients. Seventeen (55%) patients showed suppressed PA function. Suppressed function occurred more frequently in patients who had received pulses of dexamethasone in addition to DCP therapy in the first phase of treatment (P = 0.055). Suppressed PA function occurs in about half of patients who receive DCP therapy for pemphigus. These patients probably do not require routine replacement therapy with corticosteroids but may need supplementation during periods of stress.

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Citations

Oct 29, 2005·American Journal of Clinical Dermatology·Shih Wei YehRazzaque A Ahmed
Sep 14, 2007·The Journal of Dermatological Treatment·Ali Z MomeniAmir Momeni
Dec 2, 2017·The British Journal of Dermatology·K E HarmanP D Yesudian
Nov 25, 2003·The British Journal of Dermatology·K E HarmanUNKNOWN British Association of Dermatologists

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