Hypothalamo-pituitary-adrenal axis after a single epidural triamcinolone injection.
Endocrine
; 57(2): 308-313, 2017 Aug.
Article
em En
| MEDLINE
| ID: mdl-28674775
ABSTRACT
PURPOSE:
To quantify adrenocorticotropin and cortisol secretion after epidural glucocorticoid injection.METHODS:
Eight men (ages 25-63 year) were studied at baseline, 1, 4, and 12 weeks after triamcinolone (80 mg) injection epidurally. Adrenocorticotropin (pg/mL) and cortisol (µg/dL) were measured every 10 min for 4 h, and after Corticotropin-releasing hormone (CRH) (1 µg/kg) injection.RESULTS:
Epidural triamcinolone markedly suppressed (1) pre-CRH injection ACTH (from 18 ± 3.1 to 4.8 ± 0.4 P < 0.01) and cortisol (from 12.2 ± 1.6 to 1.6 ± 0.3 P < 0.0001) at week 1, with recovery at 4 weeks, and (2) CRH-stimulated 3-h summed ACTH (from 633 ± 116 to 129 ± 10 pg/mL, P < 0.0001), and 3-h summed cortisol at week 1 (from 385 ± 29 to 56 ± 22 µg/dL, P < 0.0001) and 4 weeks (284 ± 53; P < 0.01). Serum cortisol was <18 µg/dL in eight of eight men at 4 weeks, and six of eight men at week 12. Urinary-free cortisol (µg/24 h) remained low at week 12 baseline (60 ± 6.5); week 1 (9.0 ± 1.3, P < 0.01); week 4 (36 ± 8.6) and week 12 (38 ± 4.1). Urinary cortisol/cortisone ratios rose at week 4 only. Serum triamcinolone peaked at week 1 (16/16 samples), declining at week 4 (13/16 samples) and week 12 (6/16 samples).LIMITATIONS:
Relatively small group.CONCLUSION:
Epidural triamcinolone suppresses unstimulated and CRH-stimulated ACTH and cortisol secretion for 1-4 weeks but urinary free cortisol ≥12 weeks. Suppression of ACTH and cortisol after glucocorticoid treatment is thus complex.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sistema Hipófise-Suprarrenal
/
Triancinolona
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Sistema Hipotálamo-Hipofisário
/
Anti-Inflamatórios
Limite:
Adult
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Endocrine
Assunto da revista:
ENDOCRINOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos