Glycometabolic Alterations in Secondary Adrenal Insufficiency: Does Replacement Therapy Play a Role?
Secondary adrenal insufficiency (SAI) is a potentially life-threatening endocrine disorder due to an impairment of corticotropin (ACTH) secretion from any process affecting the hypothalamus or pituitary gland. ACTH deficit can be isolated or associated with other pituitary failures (hypopituitarism). An increased mortality due to cardiovascular, metabolic, and infectious diseases has been described in both primary and secondary adrenal insufficiency. However, few studies have provided compelling evidences on the underlying mechanism in SAI, because of the heterogeneity of the condition. Recently, some studies suggested that inappropriate glucocorticoid (GCs) replacement therapy, as for dose…
COVID-19 infection and glucocorticoids: update from the Italian Society of Endocrinology Expert Opinion on steroid replacement in adrenal insufficiency
In November 2019, the Italian Society of Endocrinology (SIE) has published a consensus statement on the tailoring of glucocorticoid replacement in adrenal insufciency [1]. A few months later, a novel severe acute respiratory syndrome coronavirus (SARS-CoV2) has been recognized as responsible for COVID-19. The outbreak has now reached pandemic level, with a high global mortality rate [2]. From February on, Italy has experienced an exponential rise in the infected which is estimated to reach 200,000 people, with an overall lethality of approximately 10% [3]. A recent Chinese series of nearly 50,000 patients with confrmed COVID-19 infection found that approximately one-out-of-fve (19%) evolve …