Hydrocortisone
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Hydrocortisone Insomnia: case report A 23-year-old pregnant woman developed insomnia during treatment with hydrocortisone [not all dosages stated]. The woman was observed at 16 weeks and 4 days of gestation due to an increase in body weight. She underwent various investigations along with oral glucose tolerance test, and was diagnosed with Cushing’s syndrome. An MRI of the adrenal gland showed left adrenal mass. At 20 weeks and 5 days of gestation, she underwent laparoscopic left adrenal adenoma resection. On the day of surgery, she received IV hydrocortisone, which was gradually reduced. However, she developed anorexia and fatigue after surgery. Hence, she received oral hydrocortisone 40 mg BID (at 6 a.m. and 2 p.m.) as cortisol replacement therapy for 3 weeks. In the third week of surgery, she developed insomnia [duration of treatment to reaction onset and outcome not stated]. Hence, the dose of hydrocortisone was reduced to 20mg at 6 a.m and 10mg at 2 p.m, which was administered orally. At 35 weeks and 6 days of gestation, she delivered a boy with an Apgar score of 10 points. Author comment: "Then, the patient began to suffer from insomnia in the third week after surgery. Considering the excessive dose of hormone replacement, the hydrocortisone was gradually reduced to 20 mg." Lin W, et al. Approach to Cushing’s syndrome in pregnancy: Two cases of Cushing’s syndrome in pregnancy and a review of the literature. Annals of Translational Medicine 7: 94, No. 18, Part A, Sep 2019. Available from: URL: 803434505 http://doi.org/10.21037/atm.2019.07.94 - China
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Reactions 16 Nov 2019 No. 1779
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