Severe cardiac insufficiency and hypoglycemia caused by acute adrenal insufficiency
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- Iwamuro Kenji
- Department of Anesthesiology, Keio University School of Medicine
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- Haraguchi Yasuhiko
- Department of Anesthesiology, Saitama Medical Center, Saitama Medical University
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- Wakaizumi Kenta
- Department of Anesthesiology, Saitama Medical Center, Saitama Medical University
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- Motoyasu Akira
- Department of Anesthesiology, Saitama Medical Center, Saitama Medical University
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- Fukuyama Tatsuya
- Department of Anesthesiology, Saitama Medical Center, Saitama Medical University
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- Koyama Kaoru
- Department of Anesthesiology, Saitama Medical Center, Saitama Medical University
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- Miyao Hideki
- Department of Anesthesiology, Saitama Medical Center, Saitama Medical University
Bibliographic Information
- Other Title
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- 難治性の低血圧,徐脈,低血糖から副腎不全と考え治療した1症例
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Abstract
Acute adrenal insufficiency is a rare but lethal event. Its symptoms are not specific, and therefore its diagnosis is frequently difficult. We report a 78-year-old man who presented with shock after a surgical procedure performed two months previously. In spite of adequate fluid resuscitation, catecholamine use, and glucose infusion, the patient's symptoms, which included hypotension, bradycardia, and hypoglycemia, persisted. Hence, we suspected acute adrenal insufficiency and administered hydrocortisone intravenously for the purpose of treatment and diagnosis. Subsequently, the patient exhibited a rapid improvement and recovery. We have described a case of acute adrenal insufficiency that manifested as hypotension, bradycardia, resistance to catecholamine use, and hypoglycemia after a surgical procedure performed two months previously. Since adrenal crisis is a life-threatening state, in cases of catecholamine-resistant cardiac insufficiency and refractory hypoglycemia, physicians should consider the possibility of an adrenal crisis and rapidly initiate steroid therapy.
Journal
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- Journal of the Japanese Society of Intensive Care Medicine
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Journal of the Japanese Society of Intensive Care Medicine 19 (1), 61-64, 2012
The Japanese Society of Intensive Care Medicine
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Details
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- CRID
- 1390001204445899392
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- NII Article ID
- 10030288209
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- NII Book ID
- AN10474053
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- ISSN
- 1882966X
- 13407988
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed