Single dose dexamethasone in treatment of congenital adrenocortical hyperplasia

Abstract

The observation that dexamethasone given normal individuals as a single dose at midnight results in low levels of plasma cortisol at 8:00 a.m., presumably by inhibiting the early-morning pituitary discharge of ACTH, stimulated investigation of the therapeutic value of dexamethasone so administered to patients with congenital adrenocortical hyperplasia. Detailed studies on four patients are presented. Results of short-and long-term treatment suggest that single, appropriately timed doses of 0.25 to 0.75 mg daily cause normalization of urinary 17-ketosteroid and pregnanetriol output, provide sufficient daily glucocorticoid for bodily needs, and simplify therapy for this disorder in adults and adolescents who have reached their mature height.