The management of glucocorticoid deficiency: Current and future perspectives

Clinica Chimica Acta; International Journal of Clinical Chemistry
Rosemary DineenMark Sherlock

Abstract

Glucocorticoid deficiency is the clinical state characterised by inadequate cortisol production. It may occur due to the primary failure of the adrenal cortex or to lack of stimulation of the adrenal cortex by adrenocorticotropic hormone. The aim of treatment of glucocorticoid deficiency is to mimic the normal physiological secretion of cortisol, in order to normalise quality of life and reverse pathological sequelae. However, the diurnal rhythm of cortisol secretion is difficult to reproduce with exogenous glucocorticoid therapy. There is wide inter- and intra-individual variability of in the dynamics of physiological glucocorticoid secretion, and glucocorticoid preparations that are currently available cannot reproduce physiological profiles. In addition, there are no reliable biomarkers to determine the adequacy of treatment. The treatment of acute glucocorticoid deficiency/ adrenal crisis involves prompt recognition and administration of parenteral hydrocortisone, rehydration, and management of electrolyte abnormalities. In the management of chronic glucocorticoid deficiency, the prevention of adrenal crisis must be balanced with avoidance of the long-term adverse effects of over-replacement. This requires close collaborati...Continue Reading

References

Mar 9, 1991·Lancet·P M RothwellP G Lawler
Jan 1, 1991·The Journal of Clinical Endocrinology and Metabolism·N V EstebanD L Loriaux
May 1, 1991·Journal of Clinical Pharmacology·H DerendorfM Krieg
Jan 1, 1986·Advances in Experimental Medicine and Biology·A Munck, P M Guyre
Jan 1, 1984·Endocrine Reviews·M E Keller-Wood, M F Dallman
Mar 1, 1997·Clinical Endocrinology·S R PeaceyA P Weetman
Mar 1, 1997·Clinical Endocrinology·T A Howlett
Feb 19, 1998·The Journal of Clinical Endocrinology and Metabolism·M V Mericq, G B Cutler
Sep 30, 1999·The New England Journal of Medicine·W ArltB Allolio
Mar 4, 2000·QJM : Monthly Journal of the Association of Physicians·T P van StaaC Cooper
May 29, 2002·Clinical Endocrinology·Kristian LøvåsEystein S Husebye
Sep 14, 2002·Endocrinology and Metabolism Clinics of North America·Bernd RichterChristine Clar
Feb 21, 2003·The New England Journal of Medicine·Mark S Cooper, Paul M Stewart
Jun 6, 2003·Lancet·Wiebke Arlt, Bruno Allolio
Oct 1, 1950·Annals of Internal Medicine·E C KENDALL
Aug 23, 1952·Journal of the American Medical Association·C G FRASERW D BIGFORD
Mar 27, 2004·Clinical Chemistry·K C Allen ChanChristopher W K Lam
Apr 27, 2005·Endocrinology and Metabolism Clinics of North America·Wiebke Arlt, Paul M Stewart
May 12, 2005·The Journal of Clinical Endocrinology and Metabolism·Isabelle E WidmerBeat Müller
Nov 3, 2005·The Journal of Clinical Endocrinology and Metabolism·J T HoD J Torpy
Mar 21, 2006·Psychoneuroendocrinology·Anders F ThomsenLars V Kessing
Aug 10, 2006·The Journal of Clinical Endocrinology and Metabolism·Helena FilipssonGudmundur Johannsson
Sep 14, 2006·The Journal of Clinical Endocrinology and Metabolism·Ragnhildur BergthorsdottirGudmundur Johannsson
Jul 5, 2007·European Journal of Endocrinology·Kristian Løvås, Eystein S Husebye
Aug 9, 2007·The Journal of Clinical Endocrinology and Metabolism·Stefanie HahnerBruno Allolio
Nov 15, 2007·The Journal of Clinical Endocrinology and Metabolism·Eleanor M GurnellV Krishna K Chatterjee
May 16, 2008·Clinical Medicine : Journal of the Royal College of Physicians of London·Wiebke Arlt
Nov 18, 2008·European Journal of Endocrinology·Martina M ErichsenEystein S Husebye
Jan 27, 2009·European Journal of Endocrinology·Miguel DebonoJohn Newell-Price
Jul 16, 2009·The Journal of Clinical Endocrinology and Metabolism·Hershel Raff
Sep 25, 2009·European Journal of Endocrinology·Katherine White, Wiebke Arlt
Oct 28, 2009·The Journal of Clinical Endocrinology and Metabolism·Martina M ErichsenEystein S Husebye
Dec 4, 2009·European Journal of Endocrinology·Stefanie HahnerBruno Allolio

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