| Abstract: | Adrenal cortical function was assessed in 20 children receiving 2·5 to 10 mg. prednisolone daily, by measuring plasma cortisol levels before and after the administration of the synthetic polypeptide β1-24, tetracosactrin (Synacthen). 18 of the children were asthmatics, one had nephrosis, and one had dermatomyositis.Adrenal function was classified as (a) abnormal response to tetracosactrin, where basal plasma cortisol and post-tetracosactrin levels did not exceed 6 μg./100 ml.; (b) partial response, where there was a rise of 5-10 μg./100 ml. in plasma cortisol following tetracosactrin but the basal levels (< 10 μg./100 ml.) were below or only slightly above the lower normal limit; (c) normal response, where there was usually at least a doubling of the basal value and an incremental increase of at least 10 μg./100 ml. in the plasma cortisol concentrations following tetracosactrin.All 6 children receiving the higher dosage of 10 mg. prednisolone daily had abnormal adrenal function. 4 receiving the lower dosage of 2·5 mg./day had satisfactory adrenal reserve. Of the 10 children receiving the intermediate dosage of 5 mg. prednisolone daily, 2 had frankly abnormal adrenocortical function, 3 had poor adrenal reserve, and 5 produced good incremental values, though their baseline cortisol levels were low. At the 5 mg. prednisolone dose adrenocortical suppression was not correlated either with duration of therapy or with age. |
