SAT334 Hypoxic Reduction Of Adrenal Steroidogenesis- The Cause Of Idiopathic Allergic Reactions
Authors: Kalinchenko Svetlana , Vorslov Leonid , Gusakova Daria , Samburskaya Olga 
Published: October 2023

Abstract
Disclosure: S. Kalinchenko: None. L. Vorslov: None. D. Gusakova: None. O. Samburskaya: None.
Hypoxic reduction of adrenal steroidogenesis - The Cause of Idiopathic Allergic Reactions
Background: This thesis discusses the occurrence of idiopathic allergic reactions, with an established absence of allergy to any trigger by allergo-tests, with the sole presence of a history of decompensated chronic stress, which led to a stress-induced decrease in adrenal steroidogenesis called “adrenal fatigue” with decreased production of the main anti-inflammatory, anti-allergic and stress hormone, cortisol. Materials and methods: The study included 10 patients aged 20 to 55 years, 8 women and 2 men, diagnosed with idiopathic allergic reactions (urticaria, toxidermia, erythema multiforme exudative, Quincke's edema). All patients were examined for steroid hormone levels using a steroid profile in saliva by mass spectrometry and performing allergy tests (to identify a possible allergen). Findings: From the anamnesis, all 10 patients had long-term chronic stress, which was already in the stage of decompensation, and according to the Beck depression scale, 8 patients showed mild (11-17 points) and medium (18-23 points) severity of depression in 2 patients. In the steroid profile of saliva in all 10 patients, a decrease below 07\ры the reference level of cortisol (700-2200 pg/ml) and cortisone (27400-39200 pg/ml) was found. After relief of acute symptoms by corticosteroids, all patients were prescribed infusion therapy with ascorbic acid at a dosage of 1,000 mg three times a week for three weeks to stimulate the adrenal glands. As a result, repeated analysis of the steroid profile of saliva showed an increase in the level of cortisol and cortisone within the reference values.Allergotests are negative for all known allergens. Interpretation: As is known, allergens play a primary role in the development of diseases such as urticaria, toxidermia, erythema multiforme, Quincke's edema. However, there are increasingly cases when it is not possible to establish the trigger that caused the development of an allergic reaction, and conducting allergy tests does not reveal the presence of allergen triggers in patients. However, these patients are united by a decrease in adrenal steroidogenesis against the background of decompensated chronic stress called “adrenal fatigue”, which manifests itself in a decrease in the level of cortisol and cortisone in the steroid profile of saliva below the reference values, which are the main anti-inflammatory, antiallergic hormones and hormones that are synthesized in response to stress, and with chronic stress, the reserves of these hormones are depleted, which provokes the development of inflammatory and allergic reactions in response to ordinary stimuli. Conclusion: Stimulation of the adrenal glands with reduced steroidogenesis is an opportunity to reduce the risk of inflammatory and allergic reactions in patients with decompensated chronic stress.
Presentation: Saturday, June 17, 2023