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TOTAL AND FREE CORTISOL IN AMNIOTIC FLUID DURING LATE PREGNANCY (1978)

Björkhem, I. ; Lantto, O. ; Lunell, N.-O. ; [et al.]

Oxford, UK : Blackwell Publishing Ltd

BJOG 85 (1978), S. 0

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ISSN: 1471-0528

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Total cortisol levels were measured in 81 samples of amniotic fluid obtained from 72 patients in the third trimester of pregnancy; 19 of them had pre-eclampsia and the remainder had no pre-eclampsia, hypertension or renal disease. In accordance with previous studies, there was a rise in the concentration of amniotic fluid cortisol with advancing gestation; the rise was steepest after 40 weeks, the amniotic fluid cortisol levels invariably being above 700 nmoI/I between 41 and 43 weeks of pregnancy. Amniotic fluid cortisol may thus be of value in diagnosing postmaturity. A relatively low correlation was found between total cortisol levels and lecithin/sphingomyelin ratios in amniotic fluid unless results were ranked for gestational age. Total cortisol concentrations in amniotic fluid obtained from patients with pre-eclampsia were significantly higher than in controls. The concentration of free cortisol in amniotic fluid changed much less than total cortisol. Thus total cortisol should be measured in studies of the fetal capacity to synthesize corticosteroids.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1471-0528.1978.tb14912.x

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Clinical value of assessing prednisolone pharmacokinetics before and after renal transplantation (1984)

Öst, L. ; Björkhem, I. ; Bahr, C.

Springer

European journal of clinical pharmacology 26 (1984), S. 363-369

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ISSN: 1432-1041

Keywords: prednisolone clearance ; transplantation ; renal transplant patients ; graft rejection ; cushingoid patients ; side effects ; endogenous hydrocortisone ; adverse effect prediction

Source: Springer Online Journal Archives 1860-2000

Topics: Chemistry and Pharmacology , Medicine

Notes: Summary The value of assessing the kinetics of prednisolone for predicting graft survival and the occurrence of adverse effects of long-term treatment with prednisolone was evaluated in 35 renal transplant patients. The subjects were given an oral test dose of 30 mg prednisolone before, shortly after and 3 months after transplantation. Serum samples were assayed for prednisolone and endogenous hydrocortisone by a specific HPLC method. Intrinsic prednisolone clearance differed less than three-fold (range 0.10–0.27 l/kg·h) between the patients and was relatively stable at different times in each of them. From the data obtained it was not possible to predict rejection episodes. If rejection occurred, however, a high clearance (≥0.20 l/kg·h) appeared to be deleterious for the outcome (p〈0.05). Patients with Cushingoid habitus did not differ from non-Cushingoid patients with respect to prednisolone clearance or endogenous hydrocortisone level. 7 out of 8 cases of steroid-related complications (steroid diabetes, psychosis, duodenal ulcer, perforation of the colon and osteonecrosis) occurred in patients with a clearance lower than 0.16 l/kg·h (ns). The one-year graft survival rate was 67% in patients with a clearance ≥0.16 l/kg·h, compared to 85% in patients with a lower clearance (ns). Although some correlation may exist between prednisolone kinetics, graft survival and steroid-related complications (not statistically significant in the present study), the predictive value of prednisolone kinetics is probably small in routine clinical work.