Cortisol, dehydroepiandrosterone sulfate, and androstenedione levels in patients with polymyalgia rheumatica during twelve months of glucocorticoid therapy.
This paper aims to evaluate adrenal gland hormone levels in patients with polymyalgia rheumatica (PMR) during glucocorticoid (GC) therapy. A lower than expected basal production of cortisol was found in active and glucocorticoid-untreated PMR patients, particularly females. The abrupt onset of PMR with clinical features similar to those of the steroid-withdrawal syndrome or adrenal insufficiency, as well as the clinical response to GC therapy in elderly people already age-disposed to an inadequate adrenal and anti-inflammatory response, might represent the most significant pathophysiological basis of the disease.
Laboratory and Division of Rheumatology, Department of Internal Medicine and Medical Specialities, University of Genova, Italy. mcutolo@unige.it
M
M
Cutolo
A
A
Sulli
C
C
Pizzorni
C
C
Craviotto
C
C
Prete
L
L
Foppiani
C
C
Salvarani
R H
RH
Straub
B
B
Seriolo
D000302:Adrenal Cortex / Q000187:drug effects / Q000378:metabolism*; D000312:Adrenal Hyperplasia, Congenital; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000378:metabolism; D000368:Aged; D000375:Aging / Q000276:immunology / Q000502:physiology; D000735:Androstenedione / Q000097:blood* / Q000378:metabolism; D019540:Area Under Curve; D015415:Biomarkers; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D003346:Corticotropin-Releasing Hormone; D003687:Dehydroepiandrosterone / Q000097:blood* / Q000378:metabolism; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000172:deficiency / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D015213:Neuroimmunomodulation; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011111:Polymyalgia Rheumatica / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D012636:Secretory Rate / Q000187:drug effects; D013737:Testis / Q000187:drug effects / Q000378:metabolism*
D015415:Biomarkers; D015850:Interleukin-6; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D000324:Adrenocorticotropic Hormone; D002097:C-Reactive Protein; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone