Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Nov;40(11):1175-1181.
doi: 10.1007/s40618-017-0691-1. Epub 2017 May 20.

The Unresolved Riddle of Glucocorticoid Withdrawal

Affiliations
Review

The Unresolved Riddle of Glucocorticoid Withdrawal

F Guerrero Pérez et al. J Endocrinol Invest. .

Abstract

Glucocorticoid (GC) therapy is the most common cause of adrenal insufficiency (AI). The real prevalence of AI after GC is unknown but it could involve more than 30% of patients. Some gene variation has been associated with the variability of hypothalamic-pituitary-adrenal (HPA) axis and this issue could contribute to the individual variation of adrenal function after GC treatment. Symptoms and signs of AI are nonspecific and frequently the diagnosis is delayed. Dosage, duration of treatment, administration route and serum cortisol value are not completely useful to predict AI. Clinical estimation of HPA suppression is difficult and biochemical testing is needed to confirm the diagnosis of AI. The different tapering regimens are based on a very low quality of evidence and considering the sizable individual variation, it is improbable that future research will find a secure GC tapering schedule for all patients. The aim of this review is to address the most important aspects in management of GC withdrawal in light of current knowledge.

Keywords: Adrenal insufficiency; Glucocorticoid; Glucocorticoid withdrawal; Hypothalamic-pituitary-adrenal axis.

Similar articles

See all similar articles

Cited by 4 articles

References

    1. Clin Endocrinol (Oxf). 2006 Jan;64(1):82-5 - PubMed
    1. Clin Endocrinol (Oxf). 2012 Nov;77(5):645-51 - PubMed
    1. N Engl J Med. 2003 Feb 20;348(8):727-34 - PubMed
    1. Eur J Endocrinol. 1996 Jul;135(1):27-33 - PubMed
    1. Curr Opin Endocrinol Diabetes Obes. 2008 Jun;15(3):244-9 - PubMed

Substances

LinkOut - more resources

Feedback