Intermittent Steroid Therapy

Publisher Website
Google Scholar
Abstract
Temporal variation in plasma cortisol, response to insulin-induced hypoglycemia and urinary excretion of 17-hydroxycorticosteroids after metyrapone ingestion and ACTH stimulation were studied in nine children receiving intermittent steroid therapy and in a tenth subject receiving daily steroid treatment. Plasma cortisol levels in the morning were normal in the steroid-treated children but fell more rapidly than in normal controls at noon. Fasting blood sugars were significantly higher, and the return to normal after insulin-induced hypoglycemia more rapid. The plasma cortisol response to hypoglycemia was markedly impaired. The metyrapone response appeared deficient in only three of nine subjects tested. The growth-hormone response to insulin hypoglycemia was normal in six of nine subjects, and the three who failed to respond to hypoglycemia showed a normal response to arginine infusion. The data indicate impairment in the functional capacity of the hypothalamic-pituitary-adrenal axis in children on intermittent steroid therapy, without evidence of impairment in growth-hormone release.