Comparison of Effects of Long-term Corticotrophin and Corticosteroid Treatment on Responses of Plasma Growth Hormone, ACTH, and Corticosteroid to Hypoglycaemia

Daly, J. R.; Fletcher, M R; Glass, David N.; Chambers, David J.; Bitensky, Lucille; Chayen, J.

doi:10.1136/bmj.2.5918.521

Cited by 31 publications

(9 citation statements)

References 13 publications

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“…Obviously, neither the temporary elevation of plasma cortisol nor the addition of exogenous ACTH depresses HPA function to any crucial extent (1,6,22). This is In agreement with the finding of a normal total amount of ACTH secreted after insulin-induced hypoglycaemia (23), although the release may be delayed (20) and the maximum response reduced (23).…”

Section: Discussionsupporting

confidence: 81%

Long‐term Treatment with Corticosteroids/ACTH in Asthmatic Children

1986

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Hypothalamic-pituitary-adrenal (HPA) function was studied in 23 children with severe bronchial asthma during and after long-term treatment with prednisolone and/or ACTH1-24 depot tetracosactrin) by means of ACTH stimulation test and insulin tolerance test. In the 14 children primarily treated with depot tetracosactrin, the cortisol levels in insulin tests were within normal limits both during and after treatment. An enhanced response to ACTH stimulation was found during the treatment period. During treatment with prednisolone a marked impairment of the adrenocortical function was found, with low basal plasma cortisol levels and subnormal response to ACTH stimulation, more marked the lower the age at the start of treatment and the higher the dose per kg body weight. After substitution with depot tetracosactrin the HPA-function was restituted, with plasma cortisol levels within normal limits. Growth hormone levels after insulin induced hypoglycemia were greater than or equal to 7 ng/ml during and after treatment with depot tetracosactrin. As long-term treatment with depot tetracosactrin has little side-effects in terms of suppression of the HPA-axis it is a useful alternative to oral prednisolone in severe asthma in children.

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Section: Discussionsupporting

confidence: 81%

Long‐term Treatment with Corticosteroids/ACTH in Asthmatic Children

1986

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“…A suppressive effect of short-acting glucocorticoids has been shown even with low maintenance doses of prednisolone (5.0-7.5 mg/day) in normal subjects in whom the total ACTH secreted and the rate of secretion of ACTH after insulin hypoglycemia were both reduced (31). The suppres- sion of ACTH secretion with all steroids, despite lower peak levels of glucocorticoid RRA activity after CA and DM compared with hydrocortisone and prednisolone, suggests that the latter two compounds gave peak levels much higher than necessary for normalization of ACTH.…”

Section: Discussionmentioning

confidence: 99%

Steroid Replacement in Addison's Disease and in Subjects Adrenalectomized for Cushing's Disease: Comparison of Various Glucocorticoids*

Khalid

Burke

Hurley

et al. 1982

The Journal of Clinical Endocrinology & Metabolism

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“…More recently, Daly et al (1974) measured growth hormone, ACTH and corticosteroid concentrations during insulin tolerance tests in three different groups of patients with rheumatoid arthritis (twelve in each group); these patients were all adults. One group was receiving corticosteroids, one ACTH and the third group neither drug.…”

Section: Juvenile Rheumatoid Arthritismentioning

confidence: 99%

The effect of administered corticosteroids on the growth of children

Preece

1976

Postgraduate Medical Journal

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SummaryThe growth-inhibiting effect of exogenous corticosteroids has been reported in many papers. Most of them have concerned the clinical problems of asthma and rheumatoid arthritis but it is probable that the underlying disease is relatively unimportant in determining the effect on growth. Steroid therapy on alternate days seems to produce less undesirable effects than steroid treatment every day and corticotrophin may be preferable.Although the mechanisms are uncertain it seems likely that the action is peripheral and certainly exogenous growth hormone does not prevent the steroid effect. A minimal dosage of corticosteroids should always be used in replacement therapy for hypopituitarism.THE harmful effects of glucocorticoids on growth are well known to all clinicians who treat children. In general, this is recognized in the management of bronchial asthma, rheumatoid arthritis and the nephrotic syndrome, as these are the most common childhood disorders that are treated with long-term corticosteroids. This poor growth may also be associated with a degree of maturational delay, which is usually observed as delayed skeletal age. The mechanism of this effect on growth and how to prevent it is not known. Investigation of the various conditions in which it occurs can, however, give us valuable insight into the pathogenesis of the poor growth and perhaps suggest ways of avoiding it.Growth retardation has long been recognized as a feature of childhood Cushing's syndrome where the source of excessive glucocorticoids is endogenous. Prader, Tanner and von Harnack (1963) described a girl who had suffered with Cushing's syndrome from 4 months to 4 years of age, at which time an adrenal adenoma was removed. By the time of the operation she was 5 2 s.d. below the mean of stature for age although her weight was well above the mean. The growth velocity over the 2 years before the operation was 3 -2 cm/year but following the surgery it increased rapidly so that it was 17-8 cm/year during the subsequent year. Growth velocity remained above the Correspondence: M. A. Preece,

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Comparison of Effects of Long-term Corticotrophin and Corticosteroid Treatment on Responses of Plasma Growth Hormone, ACTH, and Corticosteroid to Hypoglycaemia

Cited by 31 publications

References 13 publications

Long‐term Treatment with Corticosteroids/ACTH in Asthmatic Children

Long‐term Treatment with Corticosteroids/ACTH in Asthmatic Children

Steroid Replacement in Addison's Disease and in Subjects Adrenalectomized for Cushing's Disease: Comparison of Various Glucocorticoids*

The effect of administered corticosteroids on the growth of children

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