%0 Journal Article
%T An attempt to create a treatment algorithm of central adrenal insufficiency using CRH test, DHEA-S and clinical evaluation.
%A Mitsui Y
%A Iizuka Y
%A Tanaka T
%A Hara T
%A Masuda S
%A Ohnishi Y
%A Kanai M
%A Kurahashi K
%A Yoshida S
%A Kondo T
%A Kanezaki T
%A Shintani Y
%A Yamagami H
%A Yamaguchi Y
%A Fujinaka Y
%A Morimoto K
%A Shirakami A
%A Aihara KI
%A Fukumoto S
%A Abe M
%A Endo I
%A Mitsui Y
%A Iizuka Y
%A Tanaka T
%A Hara T
%A Masuda S
%A Ohnishi Y
%A Kanai M
%A Kurahashi K
%A Yoshida S
%A Kondo T
%A Kanezaki T
%A Shintani Y
%A Yamagami H
%A Yamaguchi Y
%A Fujinaka Y
%A Morimoto K
%A Shirakami A
%A Aihara KI
%A Fukumoto S
%A Abe M
%A Endo I
%J J Med Invest
%V 69
%N 3
%D 2022
%M 36244782
暂无%R 10.2152/jmi.69.287
%X Objective : To examine diagnostic performance of corticotropin-releasing hormone (CRH) test combined with baseline dehydroepiandrosterone sulfate (DHEA-S) in patients with a suspect of central adrenal insufficiency. Methods : Patients (n=215) requiring daily or intermittent hydrocortisone replacement, or no replacement were retrospectively checked with their peak cortisol after CRH test and baseline DHEA-S. Results :  None of 106 patients with the peak cortisol ≥ 17.5 µg / dL after CRH test required replacement, and all 64 patients with the peak cortisol < 10.0 µg / dL required daily replacement. Among 8 patients with 10.0 µg / dL ≤ the peak cortisol < 17.5 µg / dL and baseline DHEA-S below the reference range, 6 patients required daily replacement and 1 patient was under intermittent replacement. Among 37 patients with 10.0 µg / dL ≤ the peak cortisol < 17.5 µg / dL and baseline DHEA-S within the reference range, 10 and 6 patients were under intermittent and daily replacement, respectively. Conclusions : No patients with the peak cortisol ≥ 17.5 µg / dL required hydrocortisone replacement, and all patients with the peak cortisol below 10.0 µg / dL required daily replacement. Careful clinical evaluation was required to determine requirement for replacement in patients with 10.0 µg / dL ≤ the peak cortisol < 17.5 µg / dL even in combination with baseline DHEA-S. J. Med. Invest. 69 : 287-293, August, 2022.