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Mycopathologia

, Volume 127, Issue 2, pp 89–93 | Cite as

Systematic evaluation of the adrenocortical function in patients with paracoccidioidomycosis

  • Arnaldo L. Colombo
  • Samir Faiçal
  • Claudio E. Kater
Human And Animal Mycology

Abstract

Limited cortisol response to ACTH stimulation has been documented in 22 to 48% of patients with paracoccidioidomycosis (PM). Different approaches to interpret the test and inadequate selection of patients preclude an accurate appraisal of the actual incidence of adrenal insufficiency in PM. Rapid cosyntropin (ACTH) stimulation tests were performed in 38 consecutive patients (9 with the localized and 29 with the disseminated form of PM) and 40 normal controls. Subnormal cortisol responses to ACTH (60 minutes post-ACTH values below 455 nmol/l, 95% confidence limits) were found in only 4 patients (14%) with disseminated PM. If a retrospective sample of 6 patients studied previously (in whom tests were indicated due to clinical suspicion of Addison's disease) were included, or if the absolute cortisol increment above baseline was used for interpretation, we would find figures closer to those previously reported (23 and 24%, respectively). These data reflect that non-systematic evaluation or selection of a substandard criterion to interpret the test overestimates the frequency of adrenocortical insufficiency in PM.

Key words

Adrenocortical function Paracoccidioimycosis 

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Copyright information

© Kluwer Academic Publishers 1994

Authors and Affiliations

  • Arnaldo L. Colombo
    • 1
  • Samir Faiçal
  • Claudio E. Kater
    • 2
  1. 1.Devision of Infectious and Parasitic DiseasesEscola Paulista de MedicinaSao Paulo, SPBrazil
  2. 2.Devision of Endocrinology (SF, CEK), Department of MedicineEscola Paulista de MedicinaSao Paulo, SPBrazil

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