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Infusion of epinephrine decreases serum levels of cortisol and 17-hydroxyprogesterone in patients with rheumatoid arthritis.
J Rheumatol. 2002 Aug; 29(8):1659-64.JR

Abstract

OBJECTIVE

To investigate the pituitary and adrenal hormone response after an intravenous epinephrine challenge in patients with rheumatoid arthritis (RA) and controls.

METHODS

Fifteen untreated female patients with RA (age 51.5 +/- 3.2 yrs) and 7 healthy female controls (48.0 +/- 4.3 yrs) were infused with epinephrine (0.05 microg/kg/min) for about 20 min. Plasma levels of adrenocorticotropic hormone (ACTH), and serum levels of cortisol, 17-hydroxyprogesterone (17OHP), and dehydroepiandrosterone sulfate (DHEAS) were analyzed at baseline and shortly after cessation of epinephrine infusion (20 min).

RESULTS

At baseline and after epinephrine infusion, serum levels of cortisol (p = 0.045) and 17OHP (p = 0.021) were higher in controls compared to patients with RA. In contrast, at baseline and after epinephrine infusion, plasma levels of ACTH and serum levels of DHEAS were similar in controls and patients. After epinephrine infusion, only the patients with RA had a significant decrease of serum cortisol (p = 0.026) and serum 17OHP (p = 0.026). Plasma levels of ACTH (p = 0.073) and serum levels of DHEAS (p = 0.055) tended to decrease.

CONCLUSION

Serum cortisol and 17OHP (cortisol precursor) were lower in patients with RA compared to controls despite similar ACTH levels. Simulation of an adrenomedullary stress response by epinephrine infusion decreased serum cortisol and 17OHP in patients but not in controls. Such a response may play an unfavorable role during a typical stress reaction in patients with RA that may lead to a more proinflammatory situation.

Authors+Show Affiliations

Department of Internal Medicine I, University Medical Center Regensburg, Germany. rainer.straub@klinik.uni-regensburg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12180725

Citation

Straub, Rainer H., et al. "Infusion of Epinephrine Decreases Serum Levels of Cortisol and 17-hydroxyprogesterone in Patients With Rheumatoid Arthritis." The Journal of Rheumatology, vol. 29, no. 8, 2002, pp. 1659-64.
Straub RH, Kittner JM, Heijnen C, et al. Infusion of epinephrine decreases serum levels of cortisol and 17-hydroxyprogesterone in patients with rheumatoid arthritis. J Rheumatol. 2002;29(8):1659-64.
Straub, R. H., Kittner, J. M., Heijnen, C., Schedlowski, M., Schmidt, R. E., & Jacobs, R. (2002). Infusion of epinephrine decreases serum levels of cortisol and 17-hydroxyprogesterone in patients with rheumatoid arthritis. The Journal of Rheumatology, 29(8), 1659-64.
Straub RH, et al. Infusion of Epinephrine Decreases Serum Levels of Cortisol and 17-hydroxyprogesterone in Patients With Rheumatoid Arthritis. J Rheumatol. 2002;29(8):1659-64. PubMed PMID: 12180725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Infusion of epinephrine decreases serum levels of cortisol and 17-hydroxyprogesterone in patients with rheumatoid arthritis. AU - Straub,Rainer H, AU - Kittner,Jens M, AU - Heijnen,Cobi, AU - Schedlowski,Manfred, AU - Schmidt,Reinhold E, AU - Jacobs,Roland, PY - 2002/8/16/pubmed PY - 2003/3/19/medline PY - 2002/8/16/entrez SP - 1659 EP - 64 JF - The Journal of rheumatology JO - J Rheumatol VL - 29 IS - 8 N2 - OBJECTIVE: To investigate the pituitary and adrenal hormone response after an intravenous epinephrine challenge in patients with rheumatoid arthritis (RA) and controls. METHODS: Fifteen untreated female patients with RA (age 51.5 +/- 3.2 yrs) and 7 healthy female controls (48.0 +/- 4.3 yrs) were infused with epinephrine (0.05 microg/kg/min) for about 20 min. Plasma levels of adrenocorticotropic hormone (ACTH), and serum levels of cortisol, 17-hydroxyprogesterone (17OHP), and dehydroepiandrosterone sulfate (DHEAS) were analyzed at baseline and shortly after cessation of epinephrine infusion (20 min). RESULTS: At baseline and after epinephrine infusion, serum levels of cortisol (p = 0.045) and 17OHP (p = 0.021) were higher in controls compared to patients with RA. In contrast, at baseline and after epinephrine infusion, plasma levels of ACTH and serum levels of DHEAS were similar in controls and patients. After epinephrine infusion, only the patients with RA had a significant decrease of serum cortisol (p = 0.026) and serum 17OHP (p = 0.026). Plasma levels of ACTH (p = 0.073) and serum levels of DHEAS (p = 0.055) tended to decrease. CONCLUSION: Serum cortisol and 17OHP (cortisol precursor) were lower in patients with RA compared to controls despite similar ACTH levels. Simulation of an adrenomedullary stress response by epinephrine infusion decreased serum cortisol and 17OHP in patients but not in controls. Such a response may play an unfavorable role during a typical stress reaction in patients with RA that may lead to a more proinflammatory situation. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/12180725/Infusion_of_epinephrine_decreases_serum_levels_of_cortisol_and_17_hydroxyprogesterone_in_patients_with_rheumatoid_arthritis_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=12180725 DB - PRIME DP - Unbound Medicine ER -