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Legh Wilkinson Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa

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Nicolette J D Verhoog Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa

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Ann Louw Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa

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pathway of the stress response ( 1 ). This in turn, has many peripheral effects, such as an increase in circulating glucocorticoids (GCs) ( 2 , 3 ). Chronic stress or prolonged exogenous GC treatment also disrupts the central homeostatic nature of GC

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Brijesh Krishnappa Department of Endocrinology, K E M Hospital and Seth G S Medical College, Mumbai, India

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Ravikumar Shah Department of Endocrinology, K E M Hospital and Seth G S Medical College, Mumbai, India

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Saba Samad Memon Department of Endocrinology, K E M Hospital and Seth G S Medical College, Mumbai, India

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Chakra Diwaker Department of Endocrinology, K E M Hospital and Seth G S Medical College, Mumbai, India

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Anurag R Lila Department of Endocrinology, K E M Hospital and Seth G S Medical College, Mumbai, India

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Virendra A Patil Department of Endocrinology, K E M Hospital and Seth G S Medical College, Mumbai, India

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Nalini S Shah Department of Endocrinology, K E M Hospital and Seth G S Medical College, Mumbai, India

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Tushar R Bandgar Department of Endocrinology, K E M Hospital and Seth G S Medical College, Mumbai, India

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therapies ( 1 ). The remaining treatment options include observation or glucocorticoid therapy and each of them can be used as the primary treatment based on clinical scenario. A recent meta-analysis concluded that patients with milder presentation be

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Yue-Yue Wang Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Qian Wu Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Lu Chen Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Wen Chen Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Tao Yang Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Xiao-Quan Xu Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Fei-Yun Wu Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Hao Hu Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Huan-Huan Chen Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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the first-line administration in the active stage, and intravenous glucocorticoids (GC) have been the mainstay of treatment for moderate-to-severe and active cases ( 2 ). However, the response rate of intravenous GC was reported as only 70–80% ( 3 , 4

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Greta B Raglan Department of Psychology, American University, Washington, District of Columbia, USA

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Louis A Schmidt Department of Psychology, Neuroscience & Behavior, McMaster University, Hamilton, Ontario, Canada

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Jay Schulkin Department of Research, American College of Obstetricians and Gynecologists, Washington, District of Columbia, USA
Department of Neuroscience, Georgetown University, Washington, District of Columbia, USA

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develop treatment strategies involving glucocorticoids for generalized anxiety and depressive disorders, PTSD, social anxiety and other conditions. The purpose of this paper is to explore the interactions of glucocorticoids and CRH in the presentation of

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Arno Téblick Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Ilse Vanhorebeek Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Inge Derese Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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An Jacobs Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Renata Haghedooren Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Sofie Maebe Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Gerdien A Zeilmaker-Roest Department of Neonatal & Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands

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Enno D Wildschut Department of Neonatal & Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands

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Lies Langouche Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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Greet Van den Berghe Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

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concentrations. These data suggested that further augmentation of systemic glucocorticoid availability by exogenous administration amplifies the impaired pituitary processing of POMC into ACTH. However, whether glucocorticoid treatment in critically ill humans

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Paul-Martin Holterhus Department of Pediatrics I, Pediatric Endocrinology and Diabetology, University Hospital of Schleswig-Holstein, UKSH, Campus Kiel and Christian Albrechts University, CAU, Kiel, Germany

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Alexandra Kulle Department of Pediatrics I, Pediatric Endocrinology and Diabetology, University Hospital of Schleswig-Holstein, UKSH, Campus Kiel and Christian Albrechts University, CAU, Kiel, Germany

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Anne-Marie Till Department of Pediatrics, Pediatric Hematology and Oncology, University Hospital of Schleswig-Holstein, UKSH, Campus Lübeck, Germany

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Caroline Stille Department of Pediatrics, Pediatric Hematology and Oncology, University Hospital of Schleswig-Holstein, UKSH, Campus Lübeck, Germany

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Tabea Lamprecht Department of Pediatrics I, Pediatric Endocrinology and Diabetology, University Hospital of Schleswig-Holstein, UKSH, Campus Kiel and Christian Albrechts University, CAU, Kiel, Germany

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Simon Vieth Department of Pediatrics I, Pediatric Hematology and Oncology, University Hospital of Schleswig-Holstein, UKSH, Campus Kiel and Christian-Albrechts-University, CAU, Kiel, Germany

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Melchior Lauten Department of Pediatrics, Pediatric Hematology and Oncology, University Hospital of Schleswig-Holstein, UKSH, Campus Lübeck, Germany

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Introduction High-dose glucocorticoids are indispensable in the treatment of childhood acute lymphoblastic leukemia (ALL) ( 1 ). Two different highly potent synthetic glucocorticoids are used in the current standard protocols, namely

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Annelies van’t Westeinde Department of Women’s and Children’s Health, Karolinska Institutet and Division of Pediatrics, Unit for Pediatric Endocrinology and Metabolic Disorders, Karolinska University Hospital, Stockholm, Sweden

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Leif Karlsson Department of Women’s and Children’s Health, Karolinska Institutet and Division of Pediatrics, Unit for Pediatric Endocrinology and Metabolic Disorders, Karolinska University Hospital, Stockholm, Sweden

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Valeria Messina Department of Women’s and Children’s Health, Karolinska Institutet and Division of Pediatrics, Unit for Pediatric Endocrinology and Metabolic Disorders, Karolinska University Hospital, Stockholm, Sweden

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Lena Wallensteen Department of Women’s and Children’s Health, Karolinska Institutet and Division of Pediatrics, Unit for Pediatric Endocrinology and Metabolic Disorders, Karolinska University Hospital, Stockholm, Sweden

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Manuela Brösamle European Patient Advocacy Group for Adrenal Diseases, European Reference Network on Rare Endocrine Conditions (Endo ERN), Endo ERN Coordinating Centre, Leiden, The Netherlands

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Giorgio Dal Maso ArfSAG (Associazione Refionale Famiglie Sindrome Adreno Genitale) c/o Unita Operativa di Pediatria, Azienda Ospedaliero Universitaria di Bologna, Policlinico S Orsala-Malpighi, Bologna, Italy

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Alessandro Lazzerini Spanish Association of Congenital Adrenal Hyperplasia (CAH), Spain

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Jette Kristensen ePAG & Chair of Danish Addison Patient Association, Aarhus, Denmark

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Diana Kwast Dutch Adrenal Society NVACP, Nijkerk, The Netherlands

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Lea Tschaidse Department of Endocrinology, Medizinische Klinik IV, Klinikum der Universität München, Munich, Germany

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Matthias K Auer Department of Endocrinology, Medizinische Klinik IV, Klinikum der Universität München, Munich, Germany

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Hanna F Nowotny Department of Endocrinology, Medizinische Klinik IV, Klinikum der Universität München, Munich, Germany

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Luca Persani Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Nicole Reisch Department of Endocrinology, Medizinische Klinik IV, Klinikum der Universität München, Munich, Germany

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Svetlana Lajic Department of Women’s and Children’s Health, Karolinska Institutet and Division of Pediatrics, Unit for Pediatric Endocrinology and Metabolic Disorders, Karolinska University Hospital, Stockholm, Sweden

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treatment of congenital adrenal hyperplasia: long-term effects of excess glucocorticoid exposure . Hormone Research in Paediatrics 2018 89 362 – 371 . ( https://doi.org/10.1159/000485100 ) 31 Tardy-Guidollet V Menassa R Costa JM David M Bouvattier

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Helga Schultz Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital, Hillerød, Denmark

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Svend Aage Engelholm Department of Radiation Oncology, Rigshospitalet, Copenhagen, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Eva Harder Department of Oncology and Palliation, Nordsjællands Hospital, Hillerød, Denmark

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Ulrik Pedersen-Bjergaard Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital, Hillerød, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Peter Lommer Kristensen Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital, Hillerød, Denmark

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Introduction In patients with malignant disease, glucocorticoids are widely used on various indications. High-dose treatment is given as part of chemotherapy regimens and for treating oedema associated with metastatic spinal cord compression

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Sirazum Choudhury Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Tricia Tan Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Katharine Lazarus Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Karim Meeran Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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treatment, 24.0 mg of hydrocortisone vs 19.3 mg in the secondary cohort that remained alive. These findings suggest that even very small excesses of glucocorticoid replacement may contribute towards poorer mortality outcomes. Sherlock and colleagues

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Ditte Sofie Dahl Sørensen Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Jesper Krogh Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Åse Krogh Rasmussen Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Mikkel Andreassen Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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treatment with both short-acting and long-acting glucocorticoids was significantly more frequent in patients with classic 21-hydroxylase deficiency vs patients with non-classic form ( P  = 0.004) ( Table 2 ). Patients with the classic form received higher

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