An assessment of bone mineral density in patients with Addison's disease and isolated ACTH deficiency treated with glucocorticoid.
Glucocorticoid replacement therapy needs to be tailored to individual patient's requirements in order to avoid risk of over or under medication. We measured bone mineral density (BMD) of lumbar spine using dual X-ray absorptiometory in 10 patients with Addison's disease and 5 patients with isolated ACTH deficiency receiving glucocorticoid replacement therapy. We also examined the effect of glucocorticoid replacement on BMD. Decreased %BMD (less than 80% of age-matched controls) was found in 2 female patients who had received hydrocortisone at a dose of 14.8 and 15.4 mg/m(2)/day. In contrast, no patient receiving a hydrocortisone dose of less than 12.4 mg/m (2)/day had decreased %BMD. There was no correlation between %BMD and hydrocortisone dose (mg/m(2)), duration of therapy, or cumulative hydrocortisone dose when treated with appropriate dose of hydrocortisone (<13.6 mg/m(2)). There was also no statistically significant difference in %BMD with age. We concluded that long-term glucocorticoid replacement therapy does not induce bone loss in patients with glucocorticoid deficiency unless an excessive dose of hydrocortisone is given.
Chikada
Naoko
N
Department of Medicine, Tokyo Women's Medical University, Tokyo 162-8666, Japan.
Imaki
Toshihiro
T
Hotta
Mari
M
Sato
Kanji
K
Takano
Kazue
K
D015502:Absorptiometry, Photon; D000224:Addison Disease / Q000188:drug therapy* / Q000503:physiopathology*; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000172:deficiency*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D004305:Dose-Response Relationship, Drug; D004804:Eosinophils; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged
D005938:Glucocorticoids; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone