Abstract

FROM OVERUSE TO UNDERPRODUCTION: A CASE REPORT ON SECONDARY ADRENAL INSUFFICIENCY DUE TO GLUCOCORTICOID ABUSE

Vandana G. K., *Bala Teresa K. and Mohammed Abrar

Abstract

Adrenal insufficiency is a rare, serious condition characterized by reduced production of glucocorticoids, mineralocorticoids, and androgens due to the destruction of the adrenal gland or lack of stimulation. This case report pronounces a case on a 50-year-old female patient who was admitted to the hospital with chief complaints of loose stools and vomiting for the past 6 months with a history of pain in the abdomen. The past history reveals chronic corticosteroid intake for joint pain (Tab. Prednisolone 5 mg BD), which was abruptly discontinued 6 months ago. On examination, BP was 90/60 mmHg. Based on subjective and objective evidence along with laboratory reports, such as serum cortisol levels, the diagnosis was confirmed as secondary adrenal insufficiency. Along with symptomatic management, the patient was treated with Tab. Hydrocortisone 10 mg, Tab. Shelcal 500 mg, Tab. Calcitrol 0.25 mg, Cap. Vitamin D3 60,000 IU, and Tab. Thyronorm 25 mcg. The patient responded well to the treatment and was stabilized and discharged.

Keywords: Adrenal insufficiency, glucocorticoid-induced, Prednisolone, Serum cortisol, hypothalamic-pituitary-adrenal (HPA) axis, Adrenocorticotropic hormone (ACTH).