Adrenal cortex function in asthmatic patients following the discontinuation of chronic therapy with systemic glucocorticosteroids.
OBJECTIVE
To estimate the time it takes for adrenal cortex function in asthmatic patients to return to normal after discontinuation of chronic therapy with systemic glucocorticosteroids (GCs) and to assess the relationship between the duration of the disease, chronic therapy, and the return of the normal adrenal cortex functioning.


METHODS
The study involved 58 asthmatic patients and 31 healthy volunteers (aged 20-69 years). Adrenal cortex function was evaluated with the Synacthen short test, and determining serum and urinary free cortisol levels after 1, 3, 6, 12, 18, and 21 months following the discontinuation of systemic therapy with GCs.


RESULTS
A decreased adrenal reserve was observed 1 month after withdrawal of GCs in 50% of the chronically treated patients. Adrenal cortex function returned to normal in 55% of patients within 6 months, in 24% within 12 months, and in 14% within 15 months of discontinuation of systemic GCs administration. A significant positive correlation between the time taken for return to normal adrenal cortex function and duration of the disease and of GCs therapy was found.


CONCLUSIONS
Symptoms of adrenal failure may develop in about 50% of asthmatic patients. In the majority of patients treated long term with systemic GCs, adrenal cortex function returns to normal within 6 months following discontinuation of GCs. The time of such return depends on the duration of the disease and of therapy with systemic GCs.
Kos-Kudła
B
B
Department of Pathophysiology and Endocrinology, Silesian Medical University, Zabrze, Poland. beatakos@ka.onet.pl
Ciesielska-Kopacz
N
N
Ostrowska
Z
Z
Marek
B
B
Kajdaniuk
D
D
Staszewicz
P
P
Foltyn
W
W
D000302:Adrenal Cortex / Q000187:drug effects / Q000502:physiology*; D000328:Adult; D000368:Aged; D001249:Asthma / Q000145:classification / Q000188:drug therapy*; D016022:Case-Control Studies; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013997:Time Factors
D005938:Glucocorticoids; D006854:Hydrocortisone