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Low-dose adrenocorticotropin test in patients with the acquired immunodeficiency

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Low-dose adrenocorticotropin test in patients with the acquired immunodeficiency

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Título Low-dose adrenocorticotropin test in patients with the acquired immunodeficiency
Autor Wolff, Fernando Herz
Nhuch, Claudio
Stefani, Luciana Paula Cadore
Glitz, Cristina Luce
Lhullier, Francisco Luiz Rodrigues
Furlanetto, Tania Weber
Abstract Adrenocortical insufficiency is a serious complication of AIDS. Usually, integrity of the hypothalamo-pituitary-adrenal (HPA) axis in AIDS patients is assessed by measuring basal cortisol levels and cortisol response to 250 g of ACTH. Recent studies suggest that a lower ACTH dose increases the sensitivity of the procedure. In the present study, we investigated the prevalence of adrenal hypofunction in AIDS patients using a low-dose ACTH test (1 g), evaluated the clinical characteristics that might suggest this diagnosis, and the diseases and/or drugs that could be associated with it. We prospectively evaluated 63 very ill AIDS patients and 16 normal controls. A standard examination assessed the presence of signs and symptoms of adrenal insufficiency. Blood samples were collected before and 30 and 40 minutes after an injection of 1 g 1-24 ACTH. No opportunistic disease, signs, symptoms or drugs were associated with an abnormal cortisol response to ACTH. The lowest stimulated cortisol level in the control group was 18.5 g/dL; cortisol levels ≥18 g/dL were taken to indicate a normal HPA axis. Test results revealed that 12/ 63 AIDS patients (19%) had an abnormal HPA axis. With these data in mind, we suggest a prospective adrenal function evaluation of all severely ill AIDS patients.
Contido em Brazilian journal of infectious diseases. Salvador. Vol. 5, n. 2 (2001), p. 53-59
Assunto Síndrome de imunodeficiência adquirida
[en] ACTH
[en] Adrenal insufficiency
[en] AIDS
[en] Cortisol
Origem Nacional
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/19464
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