Management of adrenocortical insufficiency with continuous subcutaneous hydrocortisone infusion: long-term experience in three patients

[摘要] To assess continuous subcutaneous hydrocortisone infusion (CSHI) in patients with adrenocortical insufficiency (AI) anddifficulties with oral replacement. Three patients with AI and frequent hospital admissions attributed to adrenal crises weretreated with CSHI, which was delivered via a continuous subcutaneous infusion. All three patients preferred CSHI andremained on it long term, which permitted prolonged follow-up analysis. All three patients reported symptomaticimprovement, and in two cases, reduced hospital admission rates and inpatient stay lengths were observed. The cost ofhospital admissions and overall treatment was reduced in all cases. CSHI offers a practical and acceptable alternative to oralreplacement in a subset of patients with AI. The cost of initiating and maintaining the pump is offset in the long term byreduced frequency and duration of emergency admissions. CSHI can therefore be considered in a select group of patientswho are resistant to treatment with conventional oral glucocorticoids.

[学科分类] 血液学

[关键词] Adult;Female;White;United Kingdom;Adrenal;Adrenal;Cortisol;Glucocortcoids;Adrenal insufficiency;Acute adenocortical insufficiency;Cortisol (serum);Hydrocortisone;Glucocorticoids;Continuous subcutaneous hydrocortisone infusion;Novel treatment;May;2015