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Plasma cortisol levels in acute asthma

Upender Kapoor1, Girish Tayal, S K Mittal

  • 1Department of Pharmacology, Lok Nayak Hospital, New Delhi, India. upenderkapoor@yahoo.com

Indian Journal of Pediatrics
|January 15, 2004
PubMed

Insights

Initial plasma cortisol levels do not predict treatment response in pediatric asthma exacerbations. However, higher cortisol indicates more severe asthma attacks, suggesting normal adrenal axis function under stress.

Area of Science:

  • Pediatric Emergency Medicine
  • Pulmonology
  • Endocrinology

Background:

  • Acute exacerbations of bronchial asthma are common in children.
  • Assessing the severity and predicting treatment response in pediatric asthma attacks is crucial for effective management.
  • The role of initial plasma cortisol levels in predicting response to standard treatment requires further investigation.

Purpose of the Study:

  • To determine the correlation between initial plasma cortisol levels and the severity of asthma attacks in children.
  • To investigate the relationship between initial plasma cortisol levels and the response to standard treatment for acute asthma exacerbations.
  • To evaluate the function of the hypothalamo-pituitary-adrenal axis during acute asthma exacerbations in pediatric patients.

Main Methods:

  • A study was conducted on 33 children (5-12 years) with acute asthma exacerbations not on steroids.
  • Plasma cortisol levels were measured at admission and after treatment (salbutamol nebulization).
  • Patients were categorized as responders or non-responders based on their response to salbutamol, with cortisol levels re-measured in non-responders before hydrocortisone administration.

Main Results:

  • No significant difference in initial plasma cortisol levels was observed between responders and non-responders.
  • Children with severe asthma attacks exhibited significantly higher plasma cortisol levels at admission and study end compared to those with moderate attacks.
  • Non-responders showed an 80.65% increase in plasma cortisol, while responders had a 16.49% decrease, a statistically significant difference (p<0.05).

Conclusions:

  • The hypothalamo-pituitary-adrenal axis functions normally in asthmatic patients, with cortisol levels rising in response to stress.
  • Initial plasma cortisol levels alone are insufficient to predict a patient's response to salbutamol nebulization or the need for corticosteroids.
  • Cortisol levels correlate with asthma severity, indicating the degree of physiological stress experienced by the patient.
Abstract

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