title: Successful treatment for a case of near-fatal secondary adrenal insufficiency.
abstract: A thirty-six-year old female with shock was found to be unconsciousness a few days after developing a respiratory infection. Her past medical history included autoimmune hypothyroidism. Her state of shock was not controlled by massive fluid resuscitation with a vasopressor and antibiotics. However an infusion of 250 mg methylprednisolone dramatically improved her shock state. Further examination indicated secondary acute adrenal insufficiency. Adrenal insufficiency may complicate other endocrine disorders. Accordingly, a physician should consider hypoadrenocorticism, when patients are in a state of refractory shock in spite of massive infusion with a vasopressor especially in patients with other endocrine disorders.
authors.affiliation: Department of Traumatology and Critical Care Medicine, National Defense Medical College, 3-2 Namiki Tokorozawa Saitama, Japan 359-8513. yanagawa@ndmc.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Yanagawa
authors.forename: S
authors.initials: S
authors.lastname: Nishida
authors.forename: Y
authors.initials: Y
authors.lastname: Takihata
authors.forename: H
authors.initials: H
authors.lastname: Miyawaki
mesh_terms: D000208:Acute Disease; D000309:Adrenal Insufficiency / Q000150:complications / Q000628:therapy*; D000328:Adult; D005260:Female; D006801:Humans; D009102:Multiple Organ Failure / Q000209:etiology / Q000628:therapy; D012769:Shock / Q000209:etiology / Q000628:therapy*