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Recovery of the hypothalamic‐pituitary‐adrenal axis from suppression by short‐term, high‐dose intravenous prednisolone therapy in patients with MS
Author(s) -
Wenning G. K.,
Wiethölter H.,
Schnauder G.,
Müller P. H.,
Kanduth S.,
Renn W.
Publication year - 1994
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1994.tb01679.x
Subject(s) - prednisolone , medicine , term (time) , adrenal insufficiency , anesthesia , endocrinology , physics , quantum mechanics
We have studied the recovery of the hypothalamic‐pituitary‐adrenal (HPA) axis from inhibition by short‐term, intravenous high‐dose, corticosteroid therapy (IVHDCT) without subsequent oral replacement therapy in 10 patients with relapsing‐remitting or progressive multiple sclerosis (MS) using the human corticotrophin‐releasing hormone (hCRH) test. There was significant HPA suppression with profoundly decreased basal and peak plasma ACTH and cortisol levels 24 h after cessation of therapy. However, at 48 h the pituitary response was greatly enhanced with peak ACTH concentrations rising by more than 100 % over baseline values in 7 of 10 patients. Basal and stimulated ACTH concentrations returned to pre‐treatment levels at 120 h. Basal and stimulated plasma cortisol levels remained subnormal in 6 patients 120 h after IVHDCT. We conclude that IVHDCT without oral replacement therapy in MS patients is endocrinologically safe.