Relative adrenal insufficiency in post-transplant lymphoproliferative disorder.
J Postgrad Med
;
2003 Jan-Mar; 49(1): 69-71
Artigo
em Inglês
| IMSEAR
| ID: sea-115782
ABSTRACT
Post-transplant lymphoproliferative disorder is treated with rapid decrement of immunosuppressive therapy. This cannot be achieved with ease in patients on long-term glucocorticoid therapy, as chronically suppressed adrenal glands may not be capable of mounting adequate response to stress. A 52-year-old Caucasian male presented with fever, orthostatic hypotension, lymphadenopathy and hyponatraemia. Serum cortisol levels were within normal levels with a sub optimal response to stimulation by ACTH. Hyponatraemia and orthostasis responded poorly to fluid restriction, saline and salt repletion but corrected after increasing the steroid dose. The normal baseline cortisol levels represented a stimulated adrenal gland, however, the ACTH stimulation had inadequate response. This sub optimal stimulation and a good response to increased steroids suggest the presence of relative or occult adrenal insufficiency. Relative adrenal insufficiency must be considered in patients who have received prolonged glucocorticoid therapy and have symptoms such as hypotension and/or hyponatraemia.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Humanos
/
Masculino
/
Prednisona
/
Transplante de Rim
/
Insuficiência Adrenal
/
Hormônio Adrenocorticotrópico
/
Glucocorticoides
/
Hiponatremia
/
Hipotensão Ortostática
/
Imunossupressores
Idioma:
Inglês
Revista:
J Postgrad Med
Ano de publicação:
2003
Tipo de documento:
Artigo
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