Corticotropin-Releasing-Hormon(CRH)-Test bei der Überwachung der Glucocorticoidtherapie

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Abstract
Suppression of endogenous cortisol production was assessed by a corticotropin-releasing hormone (CRH) test 24 hours after the last dose of the glucocorticoid in 48 patients (27 women and 21 men; mean age 48.9 [21-69] years) who had been taking fluocortolone for inflammatory rheumatic disease. Both during a few weeks of treatment (9 patients) and after a year (39 patients) complete suppression of endogenous cortisol production occurred in 17 patients, partial suppression in 17. This suppression did not unequivocally correlate with the dosage or duration of treatment, but there was a tendency towards it at higher dose levels (15-30 mg). Cortisol response to the CRH test was unremarkable in 14 patients. These results suggest that secondary adrenal insufficiency is to a considerable extent dependent on individual factors. Correspondingly the degree of suppression of the adrenal axis cannot be predicted for an individual patient without suitable testing.

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