Adrenal suppression in children with the human immunodeficiency virus treated with megestrol acetate

Symptoms and laboratory evidence of adrenal suppression developed in 2 chil dren with the human immunodeficiency virus after megestrol acetate (MA) the rapy was discontinued; both required transient glucocorticoid replacement t herapy. High-dose corticotropin stimulation testing performed on children w ith the human immunodeficiency virus treated or not treated with MA showed that baseline and post-corticotropin cortisol levels were extremely low in 7 of 10 treated patients and normal in 10 of 10 members of a control group (P < .01). MA may suppress adrenal function, and replacement glucocorticoid s may prevent or relieve associated symptoms at times of severe stress or o n discontinuation of: MA therapy.