الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Children with acute lymphoblastic leukemia are subjected to many factors leading to suppression of their HPA axes. These factors may be related to the malignancy or to its treatment. The main chemotherapeutic agent accused for HPA axis suppression is the glucocorticoid whether dexamethazone
or prednisone.
Dexamethazone is the commonly used steroid owing to its better medullary and central nervous system
penetration with subsequent higher incidence of medullary remission and lower incidence of meningeal leukemia. Inspite of being accused in the frequent septic episodes and in adrenal suppression it is the steroid of
choice. A positive correlation between fluconazole and adrenal insufficiency was concluded from our study and
it should be considered at high doses of the FCZ especially after prolonged supraphysiological doses of steroids.
Based on the present study it can be concluded that steroid-induced adrenal suppression is an inevitable consequence that will occur regardless of the type of the steroid used and regardless of the duration of tapering.
So the most important is prediction of the patients who are at high risk of developing acute adrenal failure. This
could be achieved through close clinical follow up of earl signs and symptoms of withdrawal syndrome and
laboratory assessment of HPA axis integrity.