The effect of thyrotoxicosis on adrenocortical reserve
| dc.contributor.author | Tsatsoulis, A. | en |
| dc.contributor.author | Johnson, E. O. | en |
| dc.contributor.author | Kalogera, C. H. | en |
| dc.contributor.author | Seferiadis, K. | en |
| dc.contributor.author | Tsolas, O. | en |
| dc.date.accessioned | 2015-11-24T19:41:48Z | |
| dc.date.available | 2015-11-24T19:41:48Z | |
| dc.identifier.issn | 0804-4643 | - |
| dc.identifier.uri | https://olympias.lib.uoi.gr/jspui/handle/123456789/24537 | |
| dc.rights | Default Licence | - |
| dc.subject | Adrenal Cortex/*metabolism | en |
| dc.subject | Adrenocorticotropic Hormone/administration & dosage/*metabolism | en |
| dc.subject | Adult | en |
| dc.subject | Antibodies/blood | en |
| dc.subject | Female | en |
| dc.subject | Humans | en |
| dc.subject | Hydrocortisone/*blood | en |
| dc.subject | Male | en |
| dc.subject | Middle Aged | en |
| dc.subject | Thyroid Gland/immunology | en |
| dc.subject | Thyroid Hormones/blood | en |
| dc.subject | Thyrotoxicosis/*blood/etiology | en |
| dc.subject | Thyrotropin/blood | en |
| dc.subject | Time Factors | en |
| dc.title | The effect of thyrotoxicosis on adrenocortical reserve | en |
| heal.abstract | OBJECTIVE: Variations in thyroid function are known to be associated with changes in adrenocortical activity. Previous studies in animals have suggested that long-standing hyperthyroidism may be associated with diminished adrenal functional reserve despite a continuing hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis. In humans, there has been no direct assessment of adrenal secretory reserve in clinical thyrotoxicosis. This study aimed to assess adrenocortical reserve in response to low-dose ACTH, following dexamethasone suppression, in patients with severe thyrotoxicosis. DESIGN AND METHODS: Ten patients (four men and six women, 30-45 years) with severe long-standing thyrotoxicosis due to Graves' disease (n=6) or toxic nodular goitre (n=4) were studied at diagnosis and again when in a stable euthyroid state following drug therapy for 8-12 months. All patients underwent ACTH stimulation tests at 0800h with ACTH(1-24) (Cortrosyn; 0.1microg/kg body weight, i.v.) following overnight suppression of the HPA axis with dexamethasone (1mg per os at 2300h). Serum cortisol was assayed at -15, 0, 15, 30, 60 and 90min after the administration of ACTH. RESULTS: The mean (+/-s.d.) peak and delta cortisol responses to ACTH (634.5+/-164nmol/l and 618+/- 196nmol/l respectively), as well as the net area under the response curve (36769+/-12188nmol/lx min) in the hyperthyroid patients were significantly lower compared with the values when the same patients were euthyroid (911+/-157nmol/l, 905+/-160nmol/l and 57652+/-10128nmol/lxmin respectively; P<0.005). Subnormal peak cortisol responses (<500nmol/l) were observed in two severely toxic patients. The findings were independent of the cause of thyrotoxicosis. CONCLUSION: In patients with severe thyrotoxicosis, cortisol secretion in response to low-dose ACTH stimulation, following dexamethasone suppression, is lower in the hyperthyroid than in the euthyroid state. It appears that thyrotoxicosis is associated with subtle impairment of adrenocortical reserve. | en |
| heal.access | campus | - |
| heal.fullTextAvailability | TRUE | - |
| heal.identifier.secondary | http://www.ncbi.nlm.nih.gov/pubmed/10700716 | - |
| heal.identifier.secondary | http://www.eje-online.org/content/142/3/231.full.pdf | - |
| heal.journalName | European Journal of Endocrinology | en |
| heal.journalType | peer-reviewed | - |
| heal.language | en | - |
| heal.publicationDate | 2000 | - |
| heal.recordProvider | Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής | el |
| heal.type | journalArticle | - |
| heal.type.el | Άρθρο Περιοδικού | el |
| heal.type.en | Journal article | en |
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