Continuous subcutaneous hydrocortisone infusion in a woman with secondary adrenal insufficiency

摘要

Adrenal insufficiency requires long-term, often life-long, administration of 15–25?mg/day hydrocortisone in two to three daily doses, though personalized adjustments may be needed [1]. Disruption of the circadian cortisol rhythm is associated with poor quality of life, sleep disturbances, asthenia, immune disturbances, and impairment of glucose/lipid metabolisms. Programmable pumps may be used for continuous subcutaneous hydrocortisone infusion (CSHI) with modulated rates that mimic the circadian rhythm of serum cortisol concentrations [2]. We report the use of CSHI in a woman with secondary adrenal insufficiency (SAI) and multiple allergic reactions, including to excipients of the standard oral hydrocortisone tablet.