Cortisone therapy

Glucocorticoids are used empirically because of the risk of coexistent adrenal insufficiency. Hydrocortisone hemisuccinate is administered intravenously (300 mg/day)

until cortisolemia results are reported ( Njcojoff ...and LoPresti 1993). If cortisol levels are appropriate to the stress levels, hydrocortisone can be safely discontinued. If cortisol levels are low or normal, a coexistent adrenal insufficiency (Schmidt's syndrome) is likely. Hydrocortisone should be continued for 7 to 10 days, and then reduced to a physiological dose of oral hydrocortisone (30 mg/day).

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