Glucocorticoid Withdrawal Syndrome following treatment of endogenous Cushing Syndrome.

ABSTRACT:

Purpose

Literature regarding endogenous Cushing syndrome (CS) largely focuses on the challenges of diagnosis, subtyping, and treatment. The enigmatic phenomenon of glucocorticoid withdrawal syndrome (GWS), due to rapid reduction in cortisol exposure following treatment of CS, is less commonly discussed but also difficult to manage. We highlight the clinical approach to navigating patients from GWS and adrenal insufficiency to full hypothalamic-pituitary-adrenal (HPA) axis recovery.

Methods

We review the literature on the pathogenesis of GWS and its clinical presentation. We provide strategies for glucocorticoid dosing and tapering, HPA axis testing, as well as pharmacotherapy and ancillary treatments for GWS symptom management.

Results

GWS can be difficult to differen

SUBMITTER: He X 

PROVIDER: S-EPMC9170649 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature