2019, Number 1
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Rev Méd Electrón 2019; 41 (1)
Glucocorticoid deprivation syndrome. Case presentation
Torres ÁA, Álvares EMC, Semper GAI, Torres ÁAY, Otero SG
Language: Spanish
References: 27
Page: 180-188
PDF size: 741.42 Kb.
ABSTRACT
The glucocorticoide deprivation symptom is the clinical symptom resulting from stoping
the exogenous administration of steroids that were used for a long time, in spite of the
administration way. It restrains the hypothalamus-pituitary-adrenal axis
and therefore reduces corticotropine production and secretion. This is the case of a
female patient, aged 54 years, with a continued steroid treatment. When stoping it,
she began to lose weight and presented difficulties for walking. Besides orthostatic
hypotension, she abruptly fell to the ground losing conciousness. She was carried to
the hospital and there were not found periferal pulses nor arterial tension, a problem
that was not solved by the active use of endovenous fluids. She kept on without
regulating normal parameters, and was re-evaluated as a corticoid deprivation
symptom and treated with prenisone. She gradually got better. The syndromes
asociated to corticod deprivation begin due to the usage of high doses, or due to the
abrupt withdrawal of a long corticotherapy. The whole of the symptoms appearing
when corticoid withdrawal is not tolerated, in the absence of the underlying disease
against which these medicines were indicated, and with a non-suppressed
hypothalamus-pituitary-adrenal axis, is considered as a syndrome of corticoide
withdrawal. In spite of its seriousness, of the frequency and importance of this
secundary effect, sometimes it is not noticed; therefore it is essential to evaluate the
indicated treatments and periodically reevaluate the treatments ordered for chronic
diseases.
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