Primary Generalized Glucocorticoid Resistance Clinical Presentation

Updated: Dec 21, 2021
  • Author: Nicolas Nicolaides, MD, PhD; Chief Editor: Robert P Hoffman, MD  more...
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The first step in evaluating a patient with suspected alterations in tissue sensitivity to glucocorticoids is to obtain a complete personal and family history, with particular attention to evidence suggesting alterations in the activity of the HPA axis. In addition, any evidence suggesting possible CNS dysfunction, such as headaches, visual impairment, or seizures, should be noted. In female subjects, the regularity of menstrual cycles should be documented. In children and adolescents, growth and sexual maturation should be evaluated carefully. [45]


Physical Examination

The physical examination should include an assessment for signs of hyperandrogenism, virilization, and glucocorticoid excess, as well as a complete neurologic examination. Arterial blood pressure should be recorded and preferably monitored over a 24-hour period. [45]