Author/Authors :
Preville-Ratelle, Sebastien Clinique de fibrose kystique - Centre hospitalier de lUniversite de Montreal (CHUM), Montreal, Canada , Coriati, Adele Institut de recherches cliniques de Montreal (IRCM), Montreal, Canada , Menard, Aurelie Institut de recherches cliniques de Montreal (IRCM), Montreal, Canada , Bourdeau, Isabelle Centre de recherche Centre hospitalier de lUniversite de Montreal (CRCHUM), Montreal, Canada , Tremblay, François Clinique de fibrose kystique - Centre hospitalier de lUniversite de Montreal (CHUM), Montreal, Canada , Berthiaume, Yves Clinique de fibrose kystique - Centre hospitalier de lUniversite de Montreal (CHUM), Montreal, Canada
Abstract :
Background. The prevalence of adrenal insufficiency (AI) in cystic fibrosis (CF) is unknown. The frequent use of glucocorticoids
(inhaled or systemic) may induce the long-term suppression of the hypothalamic-pituitary-adrenal axis. Methods. We reviewed the
results of adrenocorticotropic hormone (ACTH) stimulation tests done over a 10-year period to evaluate adrenal function in 69 CF
patients of the CHUM CF clinic. Clinical characteristics of AI patients were compared to adrenal-sufficient (AS) patients. Results. AI
was confirmed in 33 of the 69 CF patients. A higher rate of dysglycemia (P = 0.022) and of Aspergillus positive culture (P = 0.006)
was observed in AI patients compared to AS patients. Weight, CFTR genotype, and pulmonary function were comparable between AI
and AS patients. The use of systemic corticosteroids (SC) prior to the diagnosis of AI was observed in 42.4% of patients. Compared to
AI patients without SC, SC-treated AI patients were older and had a higher rate of allergic bronchopulmonary aspergillosis.
Conclusion. -is study is the first to systematically examine the presence of AI in the largest cohort of CF patients studied to date with
a prevalence of 8%. Patients treated with corticosteroids and those colonized with Aspergillus have a greater risk of AI.
