Low-dose adrenocorticotropin test in patients with the Acquired Immunodeficiency Syndrome
Braz. j. infect. dis
;
5(2): 53-59, Apr. 2001. ilus, tab
Article
in English
| LILACS
| ID: lil-301184
ABSTRACT
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 µg 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 µg), evaluated the clinical characteristics that might suggeest 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 colleted before and 30 and 40 minutes after an injection of 1 µg 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 contol group was 18.5 µg/dL; cortisol level (greather or equal) 18 µg/dL were taken to indicate a normal HPA axis. Test results revealed that 12/63 AIDS patients (19 percent) had an abnormal HPA axis. With these data in mind, we suggest a prospective adrenal function evaluation of all severely ill AIDS patients.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Hydrocortisone
/
Acquired Immunodeficiency Syndrome
/
Adrenal Insufficiency
/
Adrenocorticotropic Hormone
/
Hypothalamo-Hypophyseal System
Type of study:
Observational study
/
Prevalence study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. j. infect. dis
Journal subject:
Communicable Diseases
Year:
2001
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Federal University of Rio Grande of South/BR
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