Pituitary adrenal function during corticosteroid withdrawal in rheumatoid arthritis.

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Abstract
A series of 29 patients who had received long-term corticosteroids for rheumatoid arthritis was submitted to pituitary-adrenal function tests during withdrawal from corticosteroids. The plasma cortisol rose steadily as the corticosteroid dosage diminished. Below a dose of 5 mg prednisolone daily more subjects had a plasma cortisol level above the lower limit of normal than below it. Ten of the 29 subjects showed impaired pituitary-adrenal responsiveness as tested by the Synacthen and fasulfa-hypoglycemia tests. There was no direct correlation between duration of corticosteroid therapy and re-showed abnormal response to insulin-hypoglycemia, all subjects who had normal baseline plasma cortisol levels gave normal responses to the tests.