Planifier un sevrage aux glucocorticoïdes: stratégie diagnostique et thérapeutique [How to plan glucocorticoid withdrawal: diagnostic and therapeutic strategies]
Details
Serval ID
serval:BIB_4235F55CA7E2
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Planifier un sevrage aux glucocorticoïdes: stratégie diagnostique et thérapeutique [How to plan glucocorticoid withdrawal: diagnostic and therapeutic strategies]
Journal
Praxis
ISSN
1661-8157
Publication state
Published
Issued date
2003
Volume
92
Number
40
Pages
1675-82
Language
french
Notes
Publication types: Comparative Study ; English Abstract ; Journal Article ; Review - Publication Status: ppublish
Abstract
Glucocorticoïds are widely used in medicine and associated with numerous complications. Whenever possible, dosage reduction or treatment withdrawal should be considered as soon as possible depending on the underlying disease being treated. Administration of glucocorticoids induces a physiologic negative feed-back on the hypothalamic-pituitary-adrenal (HPA) axis and three clinical situations can be distinguished during treatment withdrawal: reactivation of the disease for which the glucocorticoids were prescribed, acute adrenal insufficiency and steroid withdrawal syndrome. Acute adrenal insufficiency is a feared complication but probably rare. It is usually seen during stress situations and can be observed long after steroid withdrawal. There is no good predictive marker to anticipate acute adrenal insufficiency and clinical evaluation of the patient remains a key element in its diagnosis. If adrenal insufficiency is suspected, HPA suppression can be assessed with dynamic tests. During stress situation, steroid administration is then recommended depending on the severity of the stress.
Keywords
Acute Disease, Adrenal Insufficiency, Adrenocorticotropic Hormone, Aged, Antimetabolites, Circadian Rhythm, Enzyme Inhibitors, Feedback, Glucocorticoids, Half-Life, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Insulin, Metyrapone, Pituitary-Adrenal System, Stress, Physiological, Substance Withdrawal Syndrome, Time Factors
Pubmed
Create date
17/11/2008 8:57
Last modification date
20/08/2019 13:44