Adrenal Axis Integrity after IV Methylprednisolone Therapy for Thyroid Eye Disease: A Retrospective Cohort Study

Clicks: 1
ID: 313433
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #90 of 94 articles by views in european journal of endocrinology

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
BACKGROUND: Only five prior studies, each involving 12 to 32 patients, have evaluated the impact of high-dose intravenous methylprednisolone (IVMP) on hypothalamic-pituitary-adrenal (HPA) axis function in patients with active moderate-to-severe thyroid eye disease (TED). Due to their small sample sizes and methodological limitations, uncertainty remains regarding the risk of adrenal suppression following this regimen. METHODS: We conducted a retrospective observational study of 127 adults with active moderate-to-severe TED treated with the standard IVMP protocol (cumulative dose: 4.5 g over 12 weeks) at the Department of Endocrinology and Metabolic Diseases, University General Hospital of Larissa, Greece. HPA axis integrity was assessed 7-10 days after the final IVMP dose using the 250-μg ACTH(1-24) stimulation test. Serum cortisol was measured at baseline, 30-, and 60-minutes post-ACTH. A peak cortisol level ≥18.1 μg/dL (≥500 nmol/L) was considered indicative of adrenal sufficiency. RESULTS: Twelve patients were excluded due to unavailability of testing or contraindications. Among the 115 patients tested, 15 (13%) had baseline cortisol ≥18.1 μg/dL. At 30 minutes, 93% achieved adequate cortisol response, and at 60 minutes, 100% met the sufficiency threshold. All patients with baseline cortisol <5 μg/dL (150 nmol/L) demonstrated intact adrenal function on dynamic testing. CONCLUSION: In this cohort, adrenal responsiveness to the 250 μg ACTH test 7-10 days after completion of IVMP was preserved in all patients, suggesting that early post-treatment secondary adrenal insufficiency is uncommon. Although reassuring, these results should be interpreted cautiously, and clinicians should continue to rely on clinical judgment, supported by biochemical testing when indicated.
Reference Key
openalex_W7161263262 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Grigoris Effraimidis, Athanasios Kasotas, Αlexandra Bargiota
Journal european journal of endocrinology
Year 2026
DOI
10.1093/ejendo/lvag077
URL
https://doi.org/10.1093/ejendo/lvag077
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.