What is a potential consequence of abruptly stopping long-term glucocorticoid therapy?

What is a potential consequence of abruptly stopping long-term glucocorticoid therapy?

• A. Hypertensive crisis
• B. Addisonian crisis
• C. Thyroid storm
• D. Anaphylactic shock

Answer: (B)

Long-term glucocorticoid use suppresses the body's own cortisol production by dampening the hypothalamic-pituitary-adrenal axis. If the medication is stopped abruptly, the adrenal glands can’t resume cortisol production quickly enough, leading to an acute adrenal crisis (Addisonian crisis). Without enough cortisol, the body struggles to maintain vascular tone and blood pressure, and patients may develop fatigue, nausea, vomiting, abdominal pain, and confusion, potentially progressing to shock. This is why gradual tapering and appropriate stress dosing are important when stopping steroids. The other conditions listed have different causes (hypertensive crisis, thyroid storm, anaphylactic shock) and are not a direct consequence of stopping glucocorticoids suddenly.

Long-term glucocorticoid use suppresses the body's own cortisol production by dampening the hypothalamic-pituitary-adrenal axis. If the medication is stopped abruptly, the adrenal glands can’t resume cortisol production quickly enough, leading to an acute adrenal crisis (Addisonian crisis). Without enough cortisol, the body struggles to maintain vascular tone and blood pressure, and patients may develop fatigue, nausea, vomiting, abdominal pain, and confusion, potentially progressing to shock. This is why gradual tapering and appropriate stress dosing are important when stopping steroids. The other conditions listed have different causes (hypertensive crisis, thyroid storm, anaphylactic shock) and are not a direct consequence of stopping glucocorticoids suddenly.