title: Acute adrenal insufficiency after large-dose glucocorticoids for spinal cord injury.
abstract: A 24- to 48-h course of large-dose glucocorticoid therapy is often used in the acute management of spinal cord injury. We describe a patient who developed adrenal insufficiency (AI) after this protocol. Although a definitive causal relationship between the steroids and AI was not established, their temporal association and the exclusion of other possible etiologies led us to postulate that AI was a complication of the steroid protocol. Clinicians should, therefore, consider AI in patients with spinal cord injury receiving glucocorticoids, a population in whom it may otherwise go undiagnosed and untreated.
authors.affiliation: Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Harish S
authors.initials: HS
authors.lastname: Lecamwasam
authors.forename: Hemanth A
authors.initials: HA
authors.lastname: Baboolal
authors.forename: Peter F
authors.initials: PF
authors.lastname: Dunn
mesh_terms: D000307:Adrenal Gland Diseases / Q000139:chemically induced* / Q000175:diagnosis; D000324:Adrenocorticotropic Hormone; D000328:Adult; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D010656:Phenylephrine / Q000627:therapeutic use; D013119:Spinal Cord Injuries / Q000150:complications* / Q000188:drug therapy*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D014662:Vasoconstrictor Agents; D010656:Phenylephrine; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone