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The Diurnal Rhythm of Adrenocorticotropic Hormone Secretion in the Assessment of the Adequacy of Replacement Therapy in Primary Chronic Adrenal Failure
Abstract
Utilization of the daily rhythm of ACTH secretion was assessed as a measure of the adequacy of replacement therapy in primary chronic adrenal failure (PCAF: Addison's disease) with glucocorticoids (GC) by assaying plasma ACTH by radioimmunoassay every 4 h for one day in three groups of patients. Patients of group 1 had PCAF (n = 14) and received replacement therapy consisting of prednisolone (5 mg at 09:00 and 2.5 mg at 14:00) and group 2 patients received dexamethasone (0.5 mg at 23:00) in combination with prednisolone (2.5 mg at 14:00). All patients with PCAF also received 0.005-0.01 mg/day of 9alpha-fluorocortisol. The control group consisted of 14 healthy volunteers. Both types of replacement therapy resulted in high levels of variability in ACTH levels as compared with that in normal subjects. The areas under the curve (AUC) of the ACTH concentration over one day were not significantly different between groups 1 and 2 or between group 2 and controls. The AUC of ACTH in group 1 was significantly larger than that in controls. The mean ACTH concentration in group 1 at 07:00 and 11:00 was significantly greater than those in the other two groups. The daily rhythm of ACTH was generally closer to normal in patients given dexamethasone. Since our own clinical experience shows that at least two thirds of patients are initially given dexamethasone and that this had to be withdrawn because of the development of overdosage syndrome (weight gain, increased appetite, insomnia), it app…
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“Dexamethasone should be avoided because Cushingoid side effects frequently appear (103).”
From Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [103]
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Cited by
Bornstein, S. R., Allolio, B., Arlt, W., Barthel, A., Don-Wauchope, A., Hammer, G. D., Husebye, E. S., Merke, D. P., Murad, M. H., Stratakis, C. A., et al. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-1710 · Cited by 1,769
“Dexamethasone should be avoided because Cushingoid side effects frequently appear (103).”
BackgroundVeldhuis, J. D., Roelfsema, F., Iranmanesh, A., Carroll, B. J., Keenan, D. M., & Pincus, S. M. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-1143 · Cited by 51
Improving outcomes in patients with adrenal insufficiency: a review of current and future treatments
Johannsson, G., Skrtic, S., Lennernäs, H., Quinkler, M., & Stewart, P. M. (2014) · Current Medical Research and Opinion · doi:10.1185/03007995.2014.925865 · Cited by 21
Metadata
- Authors
- Fadeev, V. V., Gitel', E. P., & Mel'nichenko, G. A.
- Affiliations
- Sechenov University (RU)
- Venue
- Neuroscience and Behavioral Physiology
- Published
- 2001-05
- Volume
- 31
- Issue
- 3
- Pages
- 237-242
- ISSN
- 0097-0549 (ISSN-L)
- 1573-899X
- OpenAlex
- W194674242
- Cited by
- 12
- References
- 0
- Citations by year
- 2026: 1 · 2018: 1 · 2016: 1 · 2014: 2
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Neuroscience and Behavioral Physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Keywords
- ACTH, diurnal cycle, Addison's disease, glucocorticoid replacement therapy, prednisolone, dexamethasone, ACTH secretion
- MeSH terms
- Addison Disease, Adrenocorticotropic Hormone, Circadian Rhythm, Dexamethasone, Female, Glucocorticoids, Half-Life, Humans, Male, Middle Aged, Prednisolone, Hormone Replacement Therapy
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- CoChat. (2026). Citation check: The Diurnal Rhythm of Adrenocorticotropic Hormone Secretion in the Assessment of the Adequacy of Replacement Therapy in Primary Chronic Adrenal Failure. https://app.cochat.ai/papers/10.1023/a:1010318130933
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- Fadeev, V. V., Gitel', E. P., & Mel'nichenko, G. A. (2001). The Diurnal Rhythm of Adrenocorticotropic Hormone Secretion in the Assessment of the Adequacy of Replacement Therapy in Primary Chronic Adrenal Failure. Neuroscience and Behavioral Physiology. https://doi.org/10.1023/a%3A1010318130933
