Dose adjustments of hydrocortisone and L-thyroxine in hypopituitarism associated with cholestasis

Abstract

A patient with congenital hypopituitarism associated with cholestasis is reported here. Large doses of fat-soluble hormones (hydrocortisone (20 mg/m 2/day) and L-thyroxine (14 μg/kg/day)) were needed to resolve hypoglycemia and hypothyroidism during cholestasis. The doses could be reduced to 10 mg/m2/day and 3.5 μg/kg/day, respectively, after improvement of cholestasis. Sodium valproate, which is a water-soluble drug, did not need any dose adjustments during cholestasis. Adjustment of fat-soluble hormone doses during cholestasis should be considered in patients with cholestasis. Copyright© 2006 by The Japanese Society for Pediatric Endocrinology.