Diagnosis and approach to glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome
Introduction and purpose: Primary adrenal insufficiency can result from diseases affecting the adrenal glands, while secondary adrenal insufficiency is caused by suppression of the hypothalamic-pituitary-adrenal axis. The most common cause of adrenal suppression is exogenous steroids, a condition r...
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Kazimierz Wielki University
2024-11-01
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| Series: | Journal of Education, Health and Sport |
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| Online Access: | https://apcz.umk.pl/JEHS/article/view/55790 |
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| author | Aleksandra Kiełczewska Grzegorz Szcześniak Anna Kiełczewska |
| author_facet | Aleksandra Kiełczewska Grzegorz Szcześniak Anna Kiełczewska |
| author_sort | Aleksandra Kiełczewska |
| collection | DOAJ |
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Introduction and purpose: Primary adrenal insufficiency can result from diseases affecting the adrenal glands, while secondary adrenal insufficiency is caused by suppression of the hypothalamic-pituitary-adrenal axis. The most common cause of adrenal suppression is exogenous steroids, a condition recently termed glucocorticoid-induced adrenal insufficiency (GIAI). Glucocorticoid-induced adrenal suppression is a common adverse effect of glucocorticoid therapy, which can have severe consequences. This review provides a comprehensive overview of the diagnosis and management of glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome.
Material and methods: An extensive examination of articles published in scientific journals was carried out through online research platforms PubMed and Google Scholar. We searched articles by entering keywords in appropriate configuration: “glucocorticoid-induced adrenal insufficiency”, “glucocorticoids”, “steroids”, “adrenal crisis”, “substitution therapy”, “glucocorticoid withdrawal”.
Description of the state of knowledge: Glucocorticoids are widely used in the treatment of various inflammatory and autoimmune disorders due to their potent anti-inflammatory and immunosuppressive effects. However, chronic glucocorticoid therapy can lead to a number of adverse effects, including adrenal suppression, which can result in adrenal insufficiency.
Summary: Primary care clinicians should recognize the high prevalence of glucocorticoid-induced adrenal insufficiency in patients receiving non-oral glucocorticoid formulations. The glucocorticoid withdrawal syndrome exhibits symptoms analogous to glucocorticoid-induced adrenal insufficiency. Additional data on the morbidity and mortality linked to glucocorticoid-induced adrenal insufficiency is needed to comprehend the associated health risks, which will ultimately guide the approach to care for patients tapering long-term glucocorticoid therapy.
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| format | Article |
| id | doaj-art-0db692bd812c47c886fb08fc5a4b1fe8 |
| institution | OA Journals |
| issn | 2391-8306 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Kazimierz Wielki University |
| record_format | Article |
| series | Journal of Education, Health and Sport |
| spelling | doaj-art-0db692bd812c47c886fb08fc5a4b1fe82025-08-20T02:18:15ZengKazimierz Wielki UniversityJournal of Education, Health and Sport2391-83062024-11-017010.12775/JEHS.2024.70.55790Diagnosis and approach to glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndromeAleksandra Kiełczewska0Grzegorz Szcześniak1Anna Kiełczewska2Polish Mother's Memorial Hospital Research InstituteIndependent Provincial Hospital named after Nicolaus Copernicus in Piotrków Trybunalski, ul. Rakowska 15 97-300 Piotrków Trybunalski, PolandMedical University of Warsaw, ul Żwirki i Wigury 61, 02-091 Warsaw, Poland Introduction and purpose: Primary adrenal insufficiency can result from diseases affecting the adrenal glands, while secondary adrenal insufficiency is caused by suppression of the hypothalamic-pituitary-adrenal axis. The most common cause of adrenal suppression is exogenous steroids, a condition recently termed glucocorticoid-induced adrenal insufficiency (GIAI). Glucocorticoid-induced adrenal suppression is a common adverse effect of glucocorticoid therapy, which can have severe consequences. This review provides a comprehensive overview of the diagnosis and management of glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome. Material and methods: An extensive examination of articles published in scientific journals was carried out through online research platforms PubMed and Google Scholar. We searched articles by entering keywords in appropriate configuration: “glucocorticoid-induced adrenal insufficiency”, “glucocorticoids”, “steroids”, “adrenal crisis”, “substitution therapy”, “glucocorticoid withdrawal”. Description of the state of knowledge: Glucocorticoids are widely used in the treatment of various inflammatory and autoimmune disorders due to their potent anti-inflammatory and immunosuppressive effects. However, chronic glucocorticoid therapy can lead to a number of adverse effects, including adrenal suppression, which can result in adrenal insufficiency. Summary: Primary care clinicians should recognize the high prevalence of glucocorticoid-induced adrenal insufficiency in patients receiving non-oral glucocorticoid formulations. The glucocorticoid withdrawal syndrome exhibits symptoms analogous to glucocorticoid-induced adrenal insufficiency. Additional data on the morbidity and mortality linked to glucocorticoid-induced adrenal insufficiency is needed to comprehend the associated health risks, which will ultimately guide the approach to care for patients tapering long-term glucocorticoid therapy. https://apcz.umk.pl/JEHS/article/view/55790glucocorticoid withdrawalsubstitution therapyadrenal crisissteroidsglucocorticoidsglucocorticoid-induced adrenal insufficiency |
| spellingShingle | Aleksandra Kiełczewska Grzegorz Szcześniak Anna Kiełczewska Diagnosis and approach to glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome Journal of Education, Health and Sport glucocorticoid withdrawal substitution therapy adrenal crisis steroids glucocorticoids glucocorticoid-induced adrenal insufficiency |
| title | Diagnosis and approach to glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome |
| title_full | Diagnosis and approach to glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome |
| title_fullStr | Diagnosis and approach to glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome |
| title_full_unstemmed | Diagnosis and approach to glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome |
| title_short | Diagnosis and approach to glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome |
| title_sort | diagnosis and approach to glucocorticoid induced adrenal insufficiency and glucocorticoid withdrawal syndrome |
| topic | glucocorticoid withdrawal substitution therapy adrenal crisis steroids glucocorticoids glucocorticoid-induced adrenal insufficiency |
| url | https://apcz.umk.pl/JEHS/article/view/55790 |
| work_keys_str_mv | AT aleksandrakiełczewska diagnosisandapproachtoglucocorticoidinducedadrenalinsufficiencyandglucocorticoidwithdrawalsyndrome AT grzegorzszczesniak diagnosisandapproachtoglucocorticoidinducedadrenalinsufficiencyandglucocorticoidwithdrawalsyndrome AT annakiełczewska diagnosisandapproachtoglucocorticoidinducedadrenalinsufficiencyandglucocorticoidwithdrawalsyndrome |