Adrenal suppression - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Adrenal suppression is the inadequate adrenal production of cortisol due to suppression of the hypothalamic-pituitary-adrenal axis.
It may present clinically as adrenal insufficiency in instances of rapid tapering or cessation of exogenous glucocorticoids or withdrawal from endogenous glucocorticoid excess (e.g., following treatment of Cushing disease or an adrenal tumor causing Cushing syndrome).
The adrenocorticotropic hormone stimulation test is generally the most useful test to detect adrenal suppression.
Preventive measures include minimizing corticosteroid dose and duration when possible.
Treatment consists of augmented corticosteroid therapy plus supportive care for any intercurrent stress or overt signs of adrenal insufficiency.

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Citations

Key Articles

Prete A, Bancos I. Glucocorticoid induced adrenal insufficiency. BMJ. 2021 Jul 12;374:n1380.[Abstract][Full Text]
Broersen LH, Pereira AM, Jørgensen JO, et al. Adrenal insufficiency in corticosteroids use: systematic review and meta-analysis. J Clin Endocrinol Metab. 2015 Jun;100(6):2171-80.[Abstract][Full Text]
Liu D, Ahmet A, Ward L, et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma Clin Immunol. 2013 Aug 15;9(1):30.[Abstract][Full Text]
Ahmet A, Kim H, Spier S. Adrenal suppression: a practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy. Allergy Asthma Clin Immunol. 2011 Aug 25;7(1):13.[Abstract][Full Text]
Arlt W, Society for Endocrinology Clinical Committee. Society for Endocrinology endocrine emergency guidance: emergency management of acute adrenal insufficiency (adrenal crisis) in adult patients. Endocr Connect. 2016 Sep;5(5):G1-3.[Abstract][Full Text]
Ahmet A, Kim H, Spier S. Adrenal suppression: a practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy. Allergy Asthma Clin Immunol. 2011 Aug 25;7(1):13[Abstract][Full Text]

Referenced Articles

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