What is a potential consequence of abrupt discontinuation of glucocorticoids?

Abrupt discontinuation of glucocorticoids can lead to an adrenal crisis, a serious and potentially life-threatening condition. Glucocorticoids, such as cortisol, are crucial for various physiological functions, including the regulation of metabolism, immune response, and stress. When these medications are used long-term, the body's natural production of cortisol can be suppressed due to feedback mechanisms in the hypothalamic-pituitary-adrenal (HPA) axis.

If glucocorticoids are suddenly stopped, the adrenal glands may not be able to produce enough cortisol to meet the body's needs, especially in times of stress. This can result in symptoms such as severe fatigue, low blood pressure, hypoglycemia, and electrolyte imbalances. An adrenal crisis requires immediate medical attention and can be life-threatening if not treated promptly.

This distinct endocrine challenge highlights the importance of tapering glucocorticoid therapy gradually rather than stopping it abruptly, to allow the adrenal glands time to recover their normal function and hormone production.