ABSTRACT
Acute adrenal insufficiency can result from rapid withdrawal after prolonged glucocorticosteroid administration. Gradual tapered withdrawal is less hazardous. However, even in patients who have been successfully weaned from chronic treatment with glucocorticosteroids, for one to two years afterwards a stressful situation (such as trauma, surgery or infection) may precipitate an acute adrenal crisis and necessitate the administration of large amounts of sodium chloride, glucocorticosteroids, glucose and water. Suppression of the adrenal cortex is unusual if the daily glucocorticosteroid dose is lower than the amount usually secreted physiologically. The rate at which patients can be weaned off glucocorticosteroids depends on their underlying condition and also on the dose and duration of therapy. After long-term glucocorticosteroid therapy has been discontinued the patient should continue to carry a steroid card for at least one year.
