SPECTRUM OF ADRENAL DYSFUNCTION IN PATIENTS WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME - EVALUATION OF ADRENAL AND PITUITARY RESERVE WITH ACTHAND CORTICOTROPIN-RELEASING HORMONE TESTING

Patients with acquired immunodeficiency syndrome (AIDS) have been repo rted to develop abnormalities of the endocrine system and in particula r of the hypothalamic-pituitary-adrenal (HPA) axis. To define the abno rmalities of HPA function in AIDS patients better, we performed ACTH a nd ovine corticotropin releasing hormone (oCRH) testing in a group of AIDS patients and oCRH testing in a group of healthy subjects. Our stu dy found that in AIDS patients with normal ACTH testing, oCRH testing revealed a variety of subclinical abnormalities of ACTH and cortisol r esponses. Although we did not find frank adrenal insufficiency in any of these AIDS patients, it remains to be determined if any of the subc linical abnormalities we identified are predictive of clinically signi ficant adrenal insufficiency; it may be that as AIDS patients live lon ger, the subclinical abnormalities will progress to adrenal insufficie ncy. (C) 1997, Elsevier Science Inc.