Low-dose adrenocorticotropin test in patients with the Acquired Immunodeficiency Syndrome



Título del documento: Low-dose adrenocorticotropin test in patients with the Acquired Immunodeficiency Syndrome
Revista: The brazilian journal of infectious diseases
Base de datos: PERIÓDICA
Número de sistema: 000290673
ISSN: 1413-8670
Autores: 1




Instituciones: 1Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul. Brasil
Año:
Periodo: Abr
Volumen: 5
Número: 2
Paginación: 53-59
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Experimental
Resumen en inglés Adrenocortical insufficiency is a serious complication of AIDS. Usually, integrity of the hypothalamo-pituitary-adrenal (HPA) axis in AIDS patients is assessed by measuring basal cortisol levels and cortisol response to 250 mug of ACTH. Recent studies suggest that a lower ACTH dose increases the sensitivity of the procedure. In the present study, we investigated the prevalence of adrenal hypofunction in AIDS patients using a low-dose ACTH test (1 mug), evaluated the clinical characteristics that might suggest this diagnosis, and the diseases and/or drugs that could be associated with it. We prospectively evaluated 63 very ill AIDS patients and 16 normal controls. A standard examination assessed the presence of signs and symptoms of adrenal insufficiency. Blood samples were collected before and 30 and 40 minutes after an injection of 1 mug 1-24 ACTH. No opportunistic disease, signs, symptoms or drugs were associated with an abnormal cortisol response to ACTH. The lowest stimulated cortisol level in the control group was 18.5 mug/dL; cortisol levels > or = 18 mug/dL were taken to indicate a normal HPA axis. Test results revealed that 12/63 AIDS patients (19%) had an abnormal HPA axis. With these data in mind, we suggest a prospective adrenal function evaluation of all severely ill AIDS patients
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Endocrinología,
Inmunología,
SIDA,
Adrenal insufficiency,
ACTH,
Cortisol
Keyword: Medicine,
Diagnosis,
Endocrinology,
AIDS,
Adrenal insufficiency,
ACTH,
Cortisol,
Immunology
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