Мне всё-таки кажется, что прежде выполнения КТ надпочечников разумнее посмотреть на рентгеновский снимок лёгких.
Из UpToDate'а по поводу терапии Аддисоновой болезни:
Цитата:
Because of its short half-life, the total daily dose of hydrocortisone is divided into two or three doses. Thrice daily administration mimics the day-curve of cortisol seen in healthy volunteers [6]. A typical twice-daily regimen consists of taking about two-thirds of the total dose upon arising in the morning and one-third in the afternoon to simulate the normal cortisol circadian rhythm. Three times daily regimens use decreasing doses in the morning, early afternoon, and late afternoon/early evening (eg, 10/5/2.5 mg). Most regimens avoid evening doses, because normal subjects secrete little cortisol from about 6 PM to 3 AM.
Authors recommend a variety of replacement doses, including 5 mg/m2 given thrice daily, 10 mg morning, and 5 mg in the afternoon [7], 20 mg total dose [8], and 15 to 25 mg daily given in two or three divided doses [9]. Hydrocortisone has some mineralocorticoid activity, so fludrocortisone replacement (if needed) must be decreased appropriately. Hydrocortisone dose recommendations are similar for patients with secondary adrenal insufficiency [10-12].
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Дозы, большие 20 мг/сут, как справедливо было указано уважаемым профессором Барканом, могут приводить к гиперкортизольной симптоматике.