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A Case of Protein-losing Enteropathy with an Abnormal Cortisol Response to ACTH Stimulation / 대한내분비학회지
Journal of Korean Society of Endocrinology ; : 90-95, 2005.
Artigo em Coreano | WPRIM | ID: wpr-21275
ABSTRACT
We hereby report a case of a 62-year-old male patient who was misdiagnosed with adrenal insufficiency during the course of protein-losing enteropathy caused by superior mesenteric arterial thrombosis. The patient was suspected to have adrenal insufficiency due to hyponatremia and severe weakness. The cortisol responses to the initial challenge of 250microgram ACTH were inadequate (maximum serum cortisol level after ACTH challenge was 10.9microgram/dL), while the serum albumin concentration was 1.9g/dL. Subsequently, intravenous steroid therapy was given to the patient. However, after bowel resection, the serum albumin level increased to 3.4g/dL and the cortisol response to the follow-up rapid ACTH stimulation was completely normal. Accordingly, we discontinued steroid replacement and discharged the patient without any problem. In conclusion, measuring total serum cortisol in a patient with hypo-pro-teinemia may lead to misdiagnosis of adrenal insufficiency. In such cases, caution should be exercised in interpreting the results in terms of total serum cortisol level or measurement of serum free cortisol levels should be considered.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Enteropatias Perdedoras de Proteínas / Trombose / Albumina Sérica / Hidrocortisona / Seguimentos / Insuficiência Adrenal / Hormônio Adrenocorticotrópico / Erros de Diagnóstico / Hiponatremia Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico Limite: Humanos / Masculino Idioma: Coreano Revista: Journal of Korean Society of Endocrinology Ano de publicação: 2005 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Enteropatias Perdedoras de Proteínas / Trombose / Albumina Sérica / Hidrocortisona / Seguimentos / Insuficiência Adrenal / Hormônio Adrenocorticotrópico / Erros de Diagnóstico / Hiponatremia Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico Limite: Humanos / Masculino Idioma: Coreano Revista: Journal of Korean Society of Endocrinology Ano de publicação: 2005 Tipo de documento: Artigo