Glucocorticoids
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Exacerbation of acute adrenal failure: case report A 56-year-old patient [sex not stated] with chronic obstructive pulmonary disease (COPD) developed exacerbation of acute adrenal failure during treatment with glucocorticoids. The patient had acute coronary syndrome with ST elevation myocardial infarction, and was scheduled for angioplasty with stent placement. For about 3 years, the patient had been receiving treatment with inhaled budesonide [dosage not stated], as well as formoterol and a methylxanthine. The patient also received an oral glucocorticoid [specific drug, dosage and duration of treatment not stated]. In the past, the patient had received depot betamethasone every 2–4 weeks for about 14 years [dose not stated]. Eighteen months earlier, osteoporosis had been diagnosed. During the procedure, shock developed and IV hydrocortisone hemisuccinate was administered. The patient was discharged in a stable condition. About 20 days later, the patient returned with suspected stent restenosis; symptoms included weakness, breathlessness, abdominal pain, nausea, tachycardia and hypotension. On examination, no restenosis was observed. Fluids and four IV doses of hydrocortisone hemisuccinate 200mg were given. The suspected diagnosis was exacerbation of iatrogenic adrenal failure. Laboratory findings included a low serum cortisol level and the absence of a 24-hour cortisol release rhythm. A CT scan showed bilateral adrenal atrophy. The patient was discharged with recommendations to continue COPD therapy along with supplementation of substitution glucocorticoid therapy [outcome not stated]. Andrys-Wawrzyniak I, et al. Adverse effects of glucocorticoids. Exacerbation of iatrogenic chronic adrenal failure in patient with acute coronary syndrome treated with glucocorticoids as a result of severe obstructive pulmonary disease. Case report. Przeglad Lekarski 67: 1093-5, No. 10, 2010 [Polish; summarised from a 803061694 translation] - Poland
0114-9954/10/1374-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 22 Oct 2011 No. 1374
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