{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:45:38Z","timestamp":1761518738429},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2004,5,18]],"date-time":"2004-05-18T00:00:00Z","timestamp":1084838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2004,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold><jats:sc>background\u2002<\/jats:sc><\/jats:bold> Glucocorticoid therapy is associated with potentially serious side\u2010effects, but there is no information available regarding glucocorticoid requirement in adult hypopituitary patients with partial ACTH deficiency.<\/jats:p><jats:p><jats:bold><jats:sc>subjects\u2002<\/jats:sc><\/jats:bold> Ten male adult hypopituitary patients with partial ACTH deficiency, baseline plasma cortisol\u00a0&gt; 200\u00a0nmol\/l but a peak stimulated cortisol\u00a0&lt;\u00a0500\u00a0nmol\/l and 10 matched healthy male control volunteers participated.<\/jats:p><jats:p><jats:bold><jats:sc>design\u2002<\/jats:sc><\/jats:bold> Patients were assigned, in a random order, to a cross\u2010over protocol of treatment for 1\u00a0week with full dose hydrocortisone (10\u00a0mg twice daily), half\u2010dose hydrocortisone (5\u00a0mg twice daily), or no treatment. All patients completed all three of the treatment limbs.<\/jats:p><jats:p><jats:bold><jats:sc>measurements\u2002<\/jats:sc><\/jats:bold> Following each treatment schedule, patients underwent an 11\u2010h cortisol day curve (CDC), and the results were compared with those from the 10 control volunteers on no glucocorticoid treatment.<\/jats:p><jats:p><jats:bold><jats:sc>results\u2002<\/jats:sc><\/jats:bold> The integrated CDC values were significantly higher in patients taking a full dose of hydrocortisone compared to controls (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001). There was no significant difference in the integrated CDC between patients on half\u2010dose (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b737) or no hydrocortisone treatment (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b713), compared to control subjects. Peak postabsorption cortisol values were higher in patients receiving full\u2010dose hydrocortisone treatment compared to controls (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001). There was no significant difference in plasma sodium concentration, blood pressure or corticosteroid\u2010binding globulin between patients on any treatment schedule and controls.<\/jats:p><jats:p><jats:bold><jats:sc>conclusion\u2002<\/jats:sc><\/jats:bold> Adult patients with pituitary disease and partial ACTH deficiency have a cortisol secretory pattern comparable to that of healthy controls. Conventional full\u2010dose replacement with 10\u00a0mg twice daily of hydrocortisone produces hypercortisolaemia, whereas half\u2010dose produces a CDC that is not statistically different from that of healthy controls. The results suggest that current conventional glucocorticoid replacement overtreats patients with partial ACTH deficiency under normal unstressed physiological conditions.<\/jats:p>","DOI":"10.1111\/j.1365-2265.2004.02035.x","type":"journal-article","created":{"date-parts":[[2004,5,24]],"date-time":"2004-05-24T11:53:37Z","timestamp":1085399617000},"page":"688-693","source":"Crossref","is-referenced-by-count":37,"title":["Conventional glucocorticoid replacement overtreats adult hypopituitary patients with partial ACTH deficiency"],"prefix":"10.1111","volume":"60","author":[{"given":"Amar","family":"Agha","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Liew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"Finucane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Baker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"O'Kelly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Tormey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,5,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1995.tb02602.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1997.d01-1748.x"},{"key":"e_1_2_6_4_1","first-page":"173","article-title":"Metabolic abnormalities in growth hormone deficient adults. 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