i don't seem to get this - temi12345

[ArchivalUser]

how does abrupt withdrawal of glucocorticoids leads to adrenal cortical insufficiency ?

how does prolonged corticosteroid therapy leads to adrenal cortical hyper function

[ArchivalUser]

long tetm steroid use = acth supressed - remove steroids and acth not up to normal yet causes no adrenal function

i think...

[ArchivalUser]

agree with creditedlemon

[ArchivalUser]

Prolonged application of exogenous glucocorticoids relieves the adrenal gland from its production function and can even atrophy. Thus, abrupt discontinuation of this therapy does not leave room for quick bounce back. However, I do not understand the physiology behind hyper-functioning. It may well happen initially but not the norm.

[ArchivalUser]

how does prolonged corticosteroid therapy leads to adrenal cortical hyper function

Not possible.

There must be adenoma.

[ArchivalUser]

Prolong steroid does not lead to hyperfunction..instead leads to atrophy of adrenal due to decrease ACTH..
Prolong adminitration of steroid causes decrease synthesis of ACTH due to negative feedback....if we abruptly stop steroid then will be decrease acth resulting in decrease cortisol..
Bt if we gradually decease steroid then decrease ssteroid leads to increase synthesis of

[ArchivalUser]

*Acth - which leads to cortisol secretion

[ArchivalUser]

thank you guys for ur contributions.

@rnpjpb and usmle200014

goljan pg 617 4th ed says the most common cause of cushing syndrome is prolonged corticosteroid therapy.

[ArchivalUser]

@temi12345

most common cause of cushing syndrome "exogenous" corticosteroid therapy which will features of cushing's but at the same time suppress adrenals due to negative feedback causing adrenal hypo function . So , it is important to stop steroids gradually to give adrenals time to recover.

[ArchivalUser]

okay thank you