Document Detail

Adrenal insufficiency secondary to glucocorticoid withdrawal in patients with brain tumor.
MedLine Citation:
PMID:  17445619     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Glucocorticoids are the main drug used to control vasogenic edema in patients with brain tumor. Rapid GC tapering may not only decompensate intracranial pressure, but also unmask SAI, and some symptoms of SAI can be mistakenly attributable to increased intracranial pressure or side effects of chemotherapy and radiation therapy. METHODS: The University of Virginia Neuro-Oncology Database was reviewed from February 2002 to January 2006, and 5 neuro-oncology patients with clinical and laboratory evidence of SAI were identified. RESULTS: In our experience, 1% of neuro-oncology patients treated with GC developed SAI. Symptoms resembled increased intracranial pressure or side effects of antineoplastic treatment. CONCLUSION: A healthy index of suspicion for this complication and use of pharmacologic testing will help avert misattribution of symptoms of SAI and its deleterious consequences.
Arnaldo Neves Da Silva; David Schiff
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  67     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-20     Completed Date:  2007-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  508-10     Citation Subset:  IM    
Division of Neuro-Oncology, Department of Neurology, University of Virginia Health System, PO Box 800432, Charlottesville, VA 22908-0432, USA. <>
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MeSH Terms
Adrenal Insufficiency / chemically induced*,  physiopathology,  prevention & control
Adrenocorticotropic Hormone / blood
Brain Edema / drug therapy*,  etiology*,  prevention & control
Brain Neoplasms / complications*,  physiopathology
Cosyntropin / diagnostic use
Drug Administration Schedule
Glucocorticoids / administration & dosage,  adverse effects*
Hypothalamo-Hypophyseal System / physiopathology
Intracranial Hypertension / drug therapy,  etiology,  prevention & control
Middle Aged
Patient Selection
Substance Withdrawal Syndrome / physiopathology*
Reg. No./Substance:
0/Glucocorticoids; 16960-16-0/Cosyntropin; 9002-60-2/Adrenocorticotropic Hormone

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