Adrenocortical Responsiveness after Alternate-Day Corticosteroid Therapy

Abstract

Plasma 17-hydroxycorticosteroid levels were measured after insulin-induced hypoglycemia in a group of 10 adults receiving alternate-day steroid therapy. In these patients, who had either idiopathic nephrotic syndrome or lupus nephritis, prednisone was administered in a single dose at 8 a.m. every 48 hours. All the patients had received alternate-day therapy for at least two months in doses ranging from 25 to 120 mg of prednisone every other day. The mean dose was 75 mg every other day. The findings in this group were compared with those of normal control subjects and with those of patients taking steroids each day in divided doses.

The resting level of plasma 17-hydroxycorticosteroids was moderately depressed in the patients taking prednisone on alternate days; however, the rise in plasma 17-hydroxycorticosteroids after hypoglycemia was equal to that of the control group and was significantly greater than that observed in patients who received daily steroid therapy.