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Eur J Endocrinol. 2017 Nov;177(5):R231-R248. doi: 10.1530/EJE-17-0154. Epub 2017 Jun 5.

MANAGEMENT OF ENDOCRINE DISEASE: Risk of overtreatment in patients with adrenal insufficiency: current and emerging aspects.

Author information

1
Endocrinology UnitASST, Carlo Poma, Mantua, Italy.
2
Department of Molecular and Translational MedicineUniversity of Brescia, Brescia, Italy.
3
Chair of EndocrinologySan Raffaele Vita-Salute University, Milan, Italy.
4
Chair of Medical OncologyUniversity of Brescia, Brescia, Italy.
5
Chair of NeurosurgerySan Raffaele Vita-Salute University, Milan, Italy.
6
Chair of EndocrinologySan Raffaele Vita-Salute University, Milan, Italy a.giustina@libero.it.

Abstract

The effects of long-term replacement therapy of adrenal insufficiency (AI) are still a matter of controversy. In fact, the established glucocorticoid replacement regimens do not completely reproduce the endogenous hormonal production and the monitoring of AI treatment may be a challenge for the lack of reliable clinical and biochemical markers. Consequently, several AI patients are frequently exposed to relative glucocorticoid excess potentially leading to develop chronic complications, such as diabetes mellitus, dyslipidemia, hypertension and fragility fractures with consequent impaired QoL and increased mortality risk. This review deals with the pathophysiological and clinical aspects concerning the over-replacement therapy of primary and secondary AI.

PMID:
28583942
DOI:
10.1530/EJE-17-0154
[Indexed for MEDLINE]

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