ID | 117738 |
タイトル別表記 | Treatment algorithm of ACTH deficiency
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著者 |
Mitsui, Yukari
Tokushima University
Iizuka, Yuto
Tokushima University
Tanaka, Tomoaki
Tokushima University
Masuda, Shiho
Tokushima University
Ohnishi, Yukiyo
Tokushima University
Kanezaki, Toshiko
Tokushima Red Cross Hospital
Shintani, Yasumi
Tokushima Red Cross Hospital
Yamaguchi, Yuki
Tokushima Prefecture Naruto Hospital
Fujinaka, Yuichi
Tokushima Prefecture Naruto Hospital
森本, 佳奈
Tokushima Prefectural Central Hospital
Shirakami, Atsuhisa
Tokushima Prefectural Central Hospital
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キーワード | central adrenal insufficiency
corticotropin-releasing hormone (CRH) test
dehydroepiandrosterone-sulfate (DHEA-S)
retrospective cohort study
treatment algorithm
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資料タイプ |
学術雑誌論文
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抄録 | Objective : To examine diagnostic performance of corticotropin-releasing hormone (CRH) test combined with baseline dehydroepiandrosterone sulfate (DHEA-S) in patients with a suspect of central adrenal insufficiency. Methods : Patients (n=215) requiring daily or intermittent hydrocortisone replacement, or no replacement were retrospectively checked with their peak cortisol after CRH test and baseline DHEA-S. Results : None of 106 patients with the peak cortisol ≥ 17.5 μg / dL after CRH test required replacement, and all 64 patients with the peak cortisol < 10.0 μg / dL required daily replacement. Among 8 patients with 10.0 μg / dL ≤ the peak cortisol < 17.5 μg / dL and baseline DHEA-S below the reference range, 6 patients required daily replacement and 1 patient was under intermittent replacement. Among 37 patients with 10.0 μg / dL ≤ the peak cortisol < 17.5 μg / dL and baseline DHEA-S within the reference range, 10 and 6 patients were under intermittent and daily replacement, respectively. Conclusions : No patients with the peak cortisol ≥ 17.5 μg / dL required hydrocortisone replacement, and all patients with the peak cortisol below 10.0 μg / dL required daily replacement. Careful clinical evaluation was required to determine requirement for replacement in patients with 10.0 μg / dL ≤ the peak cortisol < 17.5 μg / dL even in combination with baseline DHEA-S.
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掲載誌名 |
The Journal of Medical Investigation
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ISSN | 13496867
13431420
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cat書誌ID | AA11166929
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出版者 | Tokushima University Faculty of Medicine
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巻 | 69
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号 | 3-4
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開始ページ | 287
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終了ページ | 293
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並び順 | 287
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発行日 | 2022-08
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EDB ID | |
出版社版DOI | |
出版社版URL | |
フルテキストファイル | |
言語 |
eng
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著者版フラグ |
出版社版
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部局 |
医学系
病院
先端酵素学研究所
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