Hypothalamic/pituitary/adrenal function in patients treated with intermittent high-dose prednisolone and cytotoxic chemotherapy.
Hypothalamic/pituitary/adrenal (H.P.A.) function was assessed in ten patients receiving intermittent high-dose prednisolone and cytotoxic chemotherapy for myeloma of lymphoma in order to predict their possible requirement for additional steroid therapy between and at the end of treatment courses. Standard insulin hypoglycaemia tests performed 36 hours after the last dose of prednisolone often demonstrated impairment of corticotrophin (adrenocorticotrophic hormone, A.C.T.H.) and growth-hormone responses, indicating hypothalamic/pituitary suppression; plasma-corticosteroid responses to endogenous A.C.T.H. and tetracosactrin were abnormal in two patients, indicating secondary adrenal suppression. Such hypothalamic/pituitary and adrenal suppression may make these patients susceptible to acute adrenal insufficiency in times of stress. H.P.A. function should be fully assessed on completion of chemotherapy.
D000305:Adrenal Cortex Hormones / Q000097:blood; D000311:Adrenal Glands / Q000503:physiopathology*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003366:Cosyntropin; D013006:Growth Hormone / Q000097:blood; D006689:Hodgkin Disease / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology*; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D010902:Pituitary Gland / Q000503:physiopathology*; D011239:Prednisolone / Q000008:administration & dosage* / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D003366:Cosyntropin; D000324:Adrenocorticotropic Hormone; D013006:Growth Hormone; D011239:Prednisolone