Altered cortisol response and hippocampal atrophy in pediatric HIV disease.
The hippocampus is a major center for the regulation of the hypothalamic-pituitary-adrenal axis. There is experimental evidence that chronic exposure to high levels of glucocorticoids may be toxic to the hippocampus. We observed elevated mean basal and 60-min cortisol (F) levels in response to adrenocorticotropin stimulation (0.25 mg cortrosyn, i.v. bolus infusion) in 15 children with HIV infection. Furthermore, in eight of the children for whom data was available, in addition to high peripheral cortisol levels, neurologic dysfunction and hippocampal atrophy were noted on CT scan. These preliminary data suggest that in HIV-infected children an altered cortisol secretion may be associated with specific central nervous system damage.
Oberfield
S E
SE
Department of Pediatrics, New York University Medical Center, New York 10016.
Cowan
L
L
Levine
L S
LS
George
A
A
David
R
R
Litt
A
A
Rojas
V
V
Kairam
R
R
D000293:Adolescent; D000304:Adrenal Cortex Function Tests; D000324:Adrenocorticotropic Hormone; D001284:Atrophy; D002648:Child; D002675:Child, Preschool; D003345:Corticosterone / Q000378:metabolism; D003900:Desoxycorticosterone / Q000378:metabolism; D005260:Female; D015658:HIV Infections / Q000378:metabolism* / Q000473:pathology; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007223:Infant; D008297:Male; D009460:Neurologic Examination; D014057:Tomography, X-Ray Computed
D003900:Desoxycorticosterone; D000324:Adrenocorticotropic Hormone; D003345:Corticosterone; D006854:Hydrocortisone