Neurology Medical News about glucocorticoid supplementation; pituitary adenoma

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Use of morning serum cortisol level after transsphenoidal resection of pituitary adenoma to predict the need for long-term glucocorticoid supplementation
Journal of Neurosurgery, 09/09/09

Marko NF et al. – A morning total cortisol level >= 15 mug/dl in the early postoperative period after transsphenoidal surgery for pituitary adenomas is a good predictor of normal HPA function. This test has good sensitivity and accuracy and correlates well with the results of additional, definitive assays of HPA function (CST, ITT, and MTT) performed at 1–3 months postoperatively. Accordingly, it is the authors' practice to avoid exogenous perioperative glucocorticoid supplementation in patients with normal preoperative HPA function and postoperative morning total cortisol levels >= 15 mug/dl 1–2 days after transsphenoidal pituitary adenomectomy.

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