- Pathophysiology involves suppression of the hypothalamic-pituitary-adrenal axis.
- Symptoms may be related to rapid tapering or cessation of exogenous glucocorticoids (resulting in a form of secondary adrenal insufficiency) or withdrawal from endogenous glucocorticoid excess (e.g., Cushing's syndrome after treatment). Even locally administered glucocorticoids may result in adrenal suppression.
- The adrenocorticotropic hormone stimulation test is generally the most useful test to detect adrenal suppression.
- Treatment consists of augmented corticosteroid therapy plus supportive care for any intercurrent stress or overt signs of adrenal insufficiency. Preventive measures include minimising corticosteroid dose and duration when possible.
Last updated: Sep 06, 2012