In:
Hormone Research in Paediatrics, S. Karger AG, Vol. 83, No. 4 ( 2015), p. 262-267
Kurzfassung:
〈 b 〉 〈 i 〉 Aims: 〈 /i 〉 〈 /b 〉 To describe cortisol response to tetracosactide and to review the literature on adrenal function in non-classic congenital adrenal hyperplasia (NCCAH) patients. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We compared cortisol responses to tetracosactide (250 μg) between NCCAH patients and a comparison group (CG) of patients with premature pubarche and normal tetracosactide test. An adequate cortisol response was defined as a peak ≥18 μg/dl. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 We included 35 NCCAH patients (26 girls, 9 boys), whose mean age at testing was 7.0 years (0.8-15.6), and 47 patients in the CG (39 girls, 8 boys), whose mean age was 7.2 years (0.5-9.9). Baseline cortisol was significantly higher in the NCCAH group than in the CG [12.9 (4.3-22.2) vs. 9.7 (4.2-16.2) μg/dl, respectively; p = 0.0006]. NCCAH patients had lower cortisol peak response compared to the CG [18.2 (6.3-40) vs. 24.9 (12-30.3) μg/dl, respectively; p 〈 0.0001]. Peak cortisol was 〈 18 μg/dl in 21/35 (60%) NCCAH patients versus 1/47 (2.1%) in the CG. No NCCAH patients had acute adrenal insufficiency, but 2 reported severe fatigue that improved with hydrocortisone. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The cortisol response to tetracosactide was inadequate ( 〈 18 μg/dl) in 60% of patients with NCCAH. Hydrocortisone therapy may deserve consideration when major stress (surgery, trauma, childbirth) or objectively documented fatigue occurs in NCCAH patients with inadequate cortisol response.
Materialart:
Online-Ressource
ISSN:
1663-2818
,
1663-2826
Sprache:
Englisch
Verlag:
S. Karger AG
Publikationsdatum:
2015
ZDB Id:
2540224-9
