La supresión y recuperación de la respuesta suprarrenal después de un tratamiento a corto plazo con glucocorticoides en dosis altas
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Updated: Jul 23, 2026
06:59
Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test
Published on: November 13, 2016
1Department of Medicine, Kantonsspital Lucerne, Switzerland. chr.henzen.irm@bluewin.ch
Lancet (London, England)
|February 22, 2000
Resumen
El tratamiento a corto plazo con dosis altas de glucocorticoides suele suprimir la respuesta suprarrenal. Una prueba de estimulación de corticotropina en dosis bajas evalúa efectivamente la recuperación suprarrenal, generalmente dentro de los 14 días.
Área de la Ciencia:
- Endocrinología Endocrinología.
- Farmacología Farmacología.
Sus antecedentes:
- La terapia con glucocorticoides puede suprimir de manera impredecible el eje hipotálamo-pituitario-adrenal (HPA).
- La evaluación de la recuperación suprarrenal después del uso a corto plazo de glucocorticoides en dosis altas es clínicamente importante.
Objetivo del estudio:
- Para investigar la cinética de la respuesta suprarrenal después de un tratamiento a corto plazo con glucocorticoides en dosis altas.
- Evaluar la utilidad de una prueba de estimulación de corticotropina en dosis bajas en este contexto.
Principales métodos:
- Se estudiaron 75 pacientes que recibieron al menos 25 mg de prednisona al día durante 5-30 días.
- Se administró una prueba de estimulación de corticotropina intravenosa de 1 microg 30 minutos después de la interrupción del glucocorticoide.
- Pruebas repetidas en pacientes con respuestas suprimidas hasta que se alcanzaron niveles normales de cortisol.
Principales resultados:
- La supresión suprarrenal se observó en 34 de 75 pacientes.
- La recuperación de la respuesta suprarrenal ocurrió dentro de los 14 días en la mayoría de los pacientes.
- Dos pacientes experimentaron supresión suprarrenal prolongada que duró varios meses.
- No se encontró correlación entre los niveles de cortisol y la dosis o duración de los glucocorticoides.
Conclusiones:
- La supresión suprarrenal es un resultado frecuente de la terapia a corto plazo con glucocorticoides en dosis altas.
- La prueba de estimulación de corticotropina en dosis bajas es un método sensible y práctico para evaluar la función suprarrenal después del tratamiento.
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