1
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      The Glucocorticoid Insensitivity Syndrome

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Recent studies demonstrate that primary (hereditary) abnormalities in the glucocorticoid receptor gene make 6.6% of the normal population relatively ‘hypersensitive’ to glucocorticoids, while 2.3% are relatively ‘resistant’. These abnormalities might explain the well-known phenomenon that some individuals develop severe adverse effects during therapy with a low dose of glucocorticosteroids, while others do not develop side effects even during long-term therapy with a much higher dose. This heterogeneity in glucocorticoid sensitivity in the normal population might eventually allow the prediction of a ‘safe’ dose of glucocorticosteroids in individual patients. ‘Resistance’ to the beneficial clinical effects of glucocorticosteroid therapy in some patients with severe rheumatoid arthritis and asthma is probably seldom related to generalized primary (hereditary) glucocorticoid resistance. In most patients this ‘resistance’ seems to be acquired and localized to the inflammation sites, where it is caused by high local cytokine production which interferes with glucocorticoid action. Recognition of localized, acquired glucocorticoid resistance is of great importance, as alternative drug therapy with other immune-modulating drugs, such as cyclosporin and methotrexate, should be considered. Chronic high-dose glucocorticosteroid treatment in such patients insufficiently reduces symptomatology, while generalized side effects occur, as the rest of the body of the patient has a normal sensitivity to these drugs.

          Related collections

          Author and article information

          Journal
          HRE
          Horm Res Paediatr
          10.1159/issn.1663-2818
          Hormone Research in Paediatrics
          S. Karger AG
          978-3-8055-6322-2
          978-3-318-01550-8
          1663-2818
          1663-2826
          1996
          1996
          10 December 2008
          : 45
          : Suppl 1
          : 2-4
          Affiliations
          Department of Medicine, Erasmus University, Rotterdam, The Netherlands
          Article
          184815 Horm Res 1996;45:2–4
          10.1159/000184815
          8805017
          © 1996 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 3
          Categories
          Introductory Lecture

          Comments

          Comment on this article