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Adrenal reserve following treatment of Graves' orbitopathy with intravenous glucocorticoids.

The purpose of immunosuppressive treatment in Graves’ orbitopathy (GO) is to decrease inflammation and congestion of the orbital tissue (1). High-dose glucocorticoid pulse therapy is the first-line treatment in patients with active, moderate to severe GO (2). Treatment with supraphysiologic doses of glucocorticoids may suppress the hypothalamic–pituitary–adrenal (HPA) axis. Suppression of the axis may occur even at physiologic doses of exogenous steroids, when used for prolonged period (3). The aim of the present study was to assess the adrenal reserve in patients with GO, following the currently used intravenous (i.v.) glucocorticoid pulse therapy (2).