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Diagnosing unusual conditions
Adrenal, Pituitary Glands function
It appeared that Pearl could taper off of prednisone in mid - 2002 so she engaged an Endocrinologist to test her cortisol producing capabilities, namely the functioning of the hypothalamic-pituitary-adrenocortical axis. The Pituitary gland was found to be working properly. ACTH reading was 15 (over 9 is normal) but the Adrenal gland output was low. Dr expected the Adrenal gland output would increase as prednisone was tapered. Dr said Pearl should be careful in tapering because inadequate cortisol can cause coma and death. He prescribed a tapering plan which would have her off of corticosteroids in two months. She had a flare the following week and was never able to get that low on prednisone again.