Glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome: Two sides of the same coin

Noura Nachawi; Dingfeng Li; M. Cecilia Lansang

doi:10.3949/ccjm.91a.23039

ABSTRACT

Diseases of the adrenal glands can lead to primary adrenal insufficiency, and suppression of the hypothalamic-pituitary-adrenal axis can cause secondary adrenal insufficiency (adrenal suppression). The most common cause of adrenal suppression is exogenous steroids, a condition recently termed glucocorticoid-induced adrenal insufficiency (GIAI). Similarly, weaning from high doses of glucocorticoids or giving insufficient glucocorticoid replacement after curative surgery for endogenous hypercortisolism (Cushing syndrome) can lead to glucocorticoid withdrawal syndrome, which overlaps with GIAI.

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Noura Nachawi, MD⇑

Department of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI; Assistant Professor, University of Michigan, Ann Arbor, MI

Address:
Noura Nachawi, MD, 24 Frank Lloyd Wright Drive, Ste 1300, Lobby C, Ann Arbor, MI 48105; nachawin{at}med.umich.edu

28242Dingfeng Li, MD

Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH; Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH

14600M. Cecilia Lansang, MD, MPH

Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH; Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH