Addison's Disease Research Today is a free monthly online journal that collates and summarizes the latest research about Addison's Disease, including details on chronic adrenal insufficiency, treatment, causes, medication.

Cortisol levels in patients with severe community-acquired pneumonia.

Salluh JI, Verdeal JC, Mello GW, Araújo LV, Martins GA, de Sousa Santino M, Soares M

Medical-Surgical Intensive Care Unit, Instituto Nacional de Câncer, Centro de Tratamento Intensivo, Pça. Cruz Vermelha 23, 20230-130, 10 Andar, Rio de Janeiro, Brazil.

OBJECTIVES: To evaluate cortisol levels and prevalence of adrenal insufficiency in patients with severe community-acquired pneumonia (CAP). DESIGN AND SETTING: Retrospective cohort study in a 24-bed medical-surgical intensive care unit (ICU). PATIENTS: Forty patients with severe CAP admitted to the ICU from March 2003 and May 2005. MEASUREMENTS AND RESULTS: Random cortisol levels were measured up to 72[Symbol: see text]h after ICU admission. A threshold of 20[Symbol: see text]mug/dl was considered for the diagnosis of adrenal insufficiency. Median cortisol levels were 15.5[Symbol: see text]mug/dl (IQR 10.8-25.1), and 26 patients (65%) met the criteria for adrenal insufficiency. Other cutoff levels of cortisol were evaluated, and 30 patients (75%) had cortisol levels below 25[Symbol: see text]mug/dl and 19 (47.5%) had cortisol levels below 15[Symbol: see text]mug/dl. When only patients with septic shock (n[Symbol: see text]=[Symbol: see text]19) were evaluated, 12 (63%) had adrenal insufficiency. CONCLUSIONS: Relative adrenal insufficiency occurs in a high proportion of patients with severe CAP. This finding highlights the importance of measuring cortisol levels and may help explain the potential benefits of hydrocortisone infusion in these patients.

Published 22 March 2006 in Intensive Care Med, 32(4): 595-8.
Full-text of this article is available online (may require subscription).

© 2005-2008 Addison's Disease Research Today. All Rights Reserved.