Mao J, Regelson W, Kalimi M: Molecular mechanism of RU 486 action: A review. Mol Cellular Biochem 1992;109:1.
Marik PE et al: Clinical practice guidelines for the diagnosis and management of corticosteroid insufficiency in critical illness: Recommendations of an international task force. Crit Care Med 2008;36:1937.
Markou A et al: Stress-induced aldosterone hyper-secretion in a substantial subset of patients with essential hypertension. J Clin Endocrinol Metab. 2015;100:2857.
Meduri GU et al: Activation and regulation of systemic inflammation in ARDS: Rationale for prolonged glucocorticoid therapy. Chest 2009;136:1631. Meduri GU et al: Steroid treatment in ARDS: A critical appraisal of the ARDS network trial and the recent literature. Intens Care Med 2008;34:61.
Merke DP et al: Future directions in the study and management of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Ann Intern Med 2002;136:320.
Nader N, Chrousos GP, Kino T: Interactions of the circadian CLOCK system and the HPA axis. Trends Endocrinol Metab 2010;21:277.
Papanastasiou L et al: Primary aldosteronism in hypertensive patients: Clinical implications and target therapy. Eur J Clin Invest. 2014;44:697.
Pervanidou P, Kanaka-Gantenbein C, Chrousos GP: Assessment of metabolic profile in a clinical setting. Curr Opin Clin Nutr Metab Care 2006;9:589.
Preda VA et al: Etomidate in the management of hypercortisolaemia in Cushing’s syndrome: A review. Eur J Endocrinol 2012;167:137.
Tsigos C, Chrousos GP: Differential diagnosis and management of Cushing’s syndrome. Annu Rev Med 1996;47:443.
Whitaker MJ et al: An oral multiparticulate, modified-release, hydrocortisone replacement therapy that provides physiological cortisol exposure. Clin Endocrinol (Oxf) 2014;80:554.
Zannas AS, Chrousos GP. Glucocorticoid signaling drives epigenetic and transcription factors to induce key regulators of human parturition. Sci Signal 2015;8:fs19.
The patient should be placed on replacement oral hydrocor-tisone at 10 mg/m2 per day and fludrocortisone at 75 mcg/d. He should be given a MedicAlert bracelet and instructions for increased treatment at 2 times standard glucocorticoid dosage for 24 hours for minor stress and 10 times replace-ment of hydrocortisone for major stress over 48 hours.
The Gonadal Hormones & Inhibitors
George P. Chrousos, MD