Corticosteroid Physiology and Principles of Therapy

被引:37
作者
Gupta, Priyanka [1 ]
Bhatia, Vijayalakshmi [1 ]
机构
[1] Sanjay Gandhi Postgrad Inst Med Sci, Dept Endocrinol, Lucknow 226014, Uttar Pradesh, India
关键词
Corticosteroid; Hypothalamo-pituitary-adrenal axis; Replacement dose; Stress dose;
D O I
10.1007/s12098-008-0208-1
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
The adrenal cortex secretes glucocorticoids (GC), mineralocorticoids (MC) and androgens. GC maintain homeostasis, MC regulate fluid and electrolyte balance and adrenal androgens contribute to development of secondary sexual characteristics. Pharmacologic GC therapy is frequently indicated in the pediatric age group. Besides having many important side effects, prolonged high dose systemic GC therapy has a suppressive effect on endogenous steroid production. Therefore, GC therapy should be withdrawn gradually and stopped based on assessment of hypothalamo-pituitary-adrenal (HPA) axis recovery. Patients with HPA axis suppression require physiological replacement of GC along with enhancement of doses during periods of stress. Due to its immunosuppressive effects, issues about safety and efficacy of live virus vaccines in patients receiving systemic high dose GC therapy must be borne in mind. [Indian J Pediatr 2008; 75 (10) : 1039-1044] E-mail: vbhatia@sgpgi.ac.in
引用
收藏
页码:1039 / 1044
页数:6
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