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Contempo Updates | January 9, 2002 Clinician's Corner

Corticosteroid Supplementation for Adrenal Insufficiency

Douglas B. Coursin, MD; Kenneth E. Wood, DO

JAMA. 2002;287(2):236-240. doi:10.1001/jama.287.2.236.

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In 1949, the clinical introduction of cortisone, a purified glucocorticoid preparation, revolutionized medical care of patients with a host of diseases and provided life-sustaining physiologic replacement in patients with acute or chronic adrenal insufficiency (AI).¹^- 2 Case reports appeared shortly after the introduction of chronic glucocorticoid therapy describing life-threatening adrenal crises in patients with medical or surgical stresses not receiving adequate corticosteroid supplementation.³^- 4 Prior edicts suggesting large-dose, long-duration therapy were not tailored to either patient or procedure. Current recommendations about supplementation during major and minor illnesses or invasive procedures, rationale, and dosing schedules have changed.⁵^- 6 During preparation of this manuscript, we searched MEDLINE and several other evidence-based medicine databases, including the Cochrane Database of Systematic Reviews.

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Coursin DB, Wood KE. Corticosteroid Supplementation for Adrenal Insufficiency. JAMA. 2002;287(2):236-240. doi:10.1001/jama.287.2.236.

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