0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Adrenal Corticosteroid Therapy-Reply

Harry F. Klinefelter, MD; Walter L. Winkenwerder, MD; Turner Bledsoe, MD
JAMA. 1981;245(11):1118. doi:10.1001/jama.1981.03310360010004.
Text Size: A A A
Published online

ABSTRACT

In Reply.—  We are grateful to Drs Goldstein and Morris for emphasizing our point that patients receiving long-term steroid therapy should receive supplemental steroids during major stress. If they will reread the comment section, they will find this emphasized both there and in the abstract.We differ, however, with their conclusion that the low baseline values reflect significant suppression of the HPA axis. They state that 5 μg/dL is the lower limit of fasting-morning cortisol levels in normal subjects. Yet they believe that a value lower than 10 μg/dL in patients taking steroids must be regarded as evidence of partial adrenal suppression. It is difficult to understand why there should be this difference.If 5 μg/dL is considered the lower limit of normal, then only 25 of our 76 patients had baseline control cortisol levels lower than this.There are at least three reasons why "baseline" values vary, as follows:

Topics

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();