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Previous Volume 348:727-734 February 20, 2003 Number 8 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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An increase in tissue corticosteroid levels during acute illness is an important protective response. Many diseases and their treatments interfere with the normal corticosteroid response to illness and thus induce tissue corticosteroid insufficiency. In this article, we review the physiology of the corticosteroid response to acute illness, describe the clinical features of hypoadrenalism in patients with acute illness, and discuss practical issues relating to diagnosis and treatment of corticosteroid insufficiency in acutely ill patients.

The Hypothalamic–Pituitary–Adrenal Axis in Acute Illness

Cortisol is the predominant corticosteroid secreted from the adrenal cortex in humans. In a healthy, unstressed person, cortisol is secreted according to a diurnal pattern under . . . [Full Text of this Article]

Diagnosis of Corticosteroid Insufficiency during Acute Illness

Clinical Features

Laboratory Investigations

Duration of Insufficiency

Treatment of Acute Adrenal Insufficiency

Septic Shock

Other Critical Illnesses

Longer-Term Treatment

Conclusions

Source Information

From the Division of Medical Sciences, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom.

Address reprint requests to Dr. Stewart at the Division of Medical Sciences, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, United Kingdom, or at p.m.stewart@bham.ac.uk.

Related Letters:

Corticosteroid Insufficiency in Acutely Ill Patients
Annane D., Briegel J., Sprung C. L., Tritos N. A., Bloomfield R., MacMillan M., Noble D. W., Riché F., Laisné M.-J., Alves A.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:2157-2159, May 22, 2003. Correspondence

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