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Primary Culture of Rat Adrenocortical Cells and Assays of Steroidogenic Functions
Published on: March 12, 2019
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[Drug-induced adrenal insufficiency].
Sofia Flores Borsari1, Stefan Bilz1
1Klinik für Endokrinologie, Diabetologie, Osteologie und Stoffwechselerkrankungen, HOCH Kantonsspital St. Gallen.
Praxis
|May 8, 2025
Summary
Glucocorticoids (GC) and immune checkpoint inhibitors (ICI) can cause drug-induced adrenal insufficiency. Early screening and prompt diagnosis are crucial for managing these HPA-axis impacting medications.
Area of Science:
- Endocrinology
- Pharmacology
- Oncology
Background:
- The hypothalamic-pituitary-adrenal (HPA) axis is susceptible to drug-induced alterations.
- Exogenous glucocorticoids (GC) have historically been the primary cause of drug-induced adrenocortical insufficiency.
- Immune checkpoint inhibitors (ICI) represent a significant emerging cause of this condition.
Purpose of the Study:
- To summarize common drugs affecting the HPA axis, including GC, ICI, and opioids.
- To provide management recommendations for drug-induced adrenocortical insufficiency.
- To emphasize the importance of early diagnosis due to non-specific symptoms.
Main Methods:
- Review of literature on drugs impacting the HPA axis.
- Analysis of common causes of drug-induced adrenocortical insufficiency.
- Synthesis of current management strategies for implicated medications.
Main Results:
- Glucocorticoids (GC) remain a leading cause of drug-induced adrenocortical insufficiency.
- Immune checkpoint inhibitors (ICI) are increasingly recognized as a significant cause.
- Opioids are also implicated in HPA axis dysfunction.
Conclusions:
- Drug-induced adrenocortical insufficiency presents with insidious and non-specific symptoms.
- Delayed diagnosis can increase patient morbidity.
- Regular screening and prompt recognition by physicians are essential for effective management.
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