Alessandro Prete, Angela E Taylor, Irina Bancos, David J Smith, Mark A Foster, Sibylle Kohler, Violet Fazal-Sanderson, John Komninos, Donna M O'Neil, Dimitra A Vassiliadi, Christopher J Mowatt, Radu Mihai, Joanne L Fallowfield, Djillali Annane, Janet M Lord, Brian G Keevil, John A H Wass, Niki Karavitaki, Wiebke Arlt
CONTEXT: Patients with adrenal insufficiency require increased hydrocortisone cover during major stress to avoid a life-threatening adrenal crisis. However, current treatment recommendations are not evidence-based. OBJECTIVE: To identify the most appropriate mode of hydrocortisone delivery in patients with adrenal insufficiency who are exposed to major stress. DESIGN AND PARTICIPANTS: Cross-sectional study: 122 unstressed healthy subjects and 288 subjects exposed to different stressors (major trauma [N = 83], sepsis [N = 100], and combat stress [N = 105])...
July 1, 2020: Journal of Clinical Endocrinology and Metabolism