Document Detail

Early adrenocortical recovery after glucocorticoid therapy in children with leukemia.
MedLine Citation:
PMID:  15181060     Owner:  NLM     Status:  MEDLINE    
The duration of glucocorticoid-induced inhibition that occurs in the hypothalamic-pituitary-adrenal (HPA) axis after discontinuation of treatment is controversial. The main objective of this prospective study was to evaluate the inhibition of the HPA axis by dexamethasone in children and adolescents with acute lymphoid leukemia. Thirty-five patients (median age of 6.9 yr) were evaluated. A stimulus test with ovine CRH (1 microg/kg) was performed before the introduction of dexamethasone (6 mg/m2.d for 28 d), in the 8th and 28th days of glucocorticoid therapy, and 48 h and 1 month after discontinuation of glucocorticoid therapy. Suppression of the basal secretion as well as the maximum concentration of ACTH occurred during glucocorticoid therapy (P < 0.01). The pituitary function before the introduction of dexamethasone was similar to the one seen 48 h and 1 month after withdrawing it. Suppression of the adrenal function was detected during glucocorticoid therapy, which persisted for 48 h after the steroid was removed from treatment (P < 0.01). One month after ceasing the administration of the glucocorticoid, the adrenal function was similar to that before glucocorticoid therapy. According to these results, a clinical and laboratory follow-up of the HPA axis in the month after the cessation of dexamethasone therapy is suggested to determine glucocorticoid replacement.
Cristiane de Freitas Cunha; Ivani Novato Silva; Francisca Lee Finch
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  89     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-07     Completed Date:  2004-07-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2797-802     Citation Subset:  AIM; IM    
Dvision of Pediatric Endocrinology, University Hospital, Federal University of Minas Gerais, 30130-100 Belo Horizonte, Minas Gerais, Brazil.
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MeSH Terms
Adrenal Cortex / drug effects*,  physiology*
Adrenocorticotropic Hormone / blood
Biological Markers
Dexamethasone / administration & dosage,  adverse effects*
Glucocorticoids / administration & dosage,  adverse effects*
Hydrocortisone / blood
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
Prospective Studies
Reg. No./Substance:
0/Biological Markers; 0/Glucocorticoids; 50-02-2/Dexamethasone; 50-23-7/Hydrocortisone; 9002-60-2/Adrenocorticotropic Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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