An Approach to Minimising Risk of Adrenal Insufficiency When Discontinuing Oral Glucocorticoids.

Abstract:

:Oral glucocorticoids are commonly used across every field of medicine; however, discontinuing them in patients can be challenging. The risk of acute adrenal crises secondary to glucocorticoid withdrawal can be fatal and arises from chronic suppression of the adrenal glands. Identifying risk factors for adrenal suppression in dermatological patients, such as doses greater than 5 to 7.5 mg of prednisone equivalent, duration of glucocorticoid use greater than 3 weeks, certain medications, and comorbidities, can help risk-stratify patients. The use of adrenal gland testing such as basal cortisol levels and adrenocorticotropic hormone stimulation tests can confirm adrenal suppression in patients. This review article provides an approach that dermatologists can use to minimise the risk of adrenal insufficiency in patients discontinuing glucocorticoids and when it may be appropriate to use adrenal gland testing.

journal_name

J Cutan Med Surg

authors

Nicholas MN,Li SK,Dytoc M

doi

10.1177/1203475417736278

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

175-181

issue

2

eissn

1203-4754

issn

1615-7109

journal_volume

22

pub_type

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