Planifier un sevrage aux glucocorticoïdes: stratégie diagnostique et thérapeutique [How to plan glucocorticoid withdrawal: diagnostic and therapeutic strategies]

Détails

ID Serval
serval:BIB_4235F55CA7E2
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Planifier un sevrage aux glucocorticoïdes: stratégie diagnostique et thérapeutique [How to plan glucocorticoid withdrawal: diagnostic and therapeutic strategies]
Périodique
Praxis
Auteur(s)
Vollenweider P., Waeber G.
ISSN
1661-8157
Statut éditorial
Publié
Date de publication
2003
Volume
92
Numéro
40
Pages
1675-82
Langue
français
Notes
Publication types: Comparative Study ; English Abstract ; Journal Article ; Review - Publication Status: ppublish
Résumé
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.
Mots-clé
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
Création de la notice
17/11/2008 9:57
Dernière modification de la notice
03/03/2018 16:36
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