Volume : IX, Issue : VI, June - 2019

Secondary adrenal insufficiency due to the abuse of systemic corticosteroids–a growing menace in the elderly– a retrospective study

Dr. Betsy Mathew, Dr. Geetha Ann Francis, Ms. Sumithra Selvam

Abstract :

Background: Corticosteroids are beneficial and often life–saving in many diseases. Yet its misuse has resulted in life–threatening adverse effects. Secondary adrenal insufficiency due to aupt withdrawal of corticosteroid after prolonged use is one of the most feared complications. Its presentation is non–specific and in the absence of a history of corticosteroid intake, it can be misdiagnosed with serious consequences. Aims: This study was done to highlight the various non–specific presentations of secondary adrenal insufficiency and create an awareness of this problem. Methods: This was a retrospective study conducted in the geriatric medicine unit of our hospital between 2014 January and 2016 September. Charts of patients discharged with a diagnosis of chronic steroid abuse and secondary adrenal insufficiency due to hypothalamo–pituitary–adrenal axis suppression were retrieved and studied. Results: The charts of 29 patients with secondary adrenal insufficiency were analysed. Patients were aged 60–95 years (mean 70.4 years –SD 8.53). Male: female ratio was almost equal (1.07:1). Corticosteroid use was definitely documented in 11 patients (37.93 %) and duration of use varied from 1 year to 40 years with route of administration being parenteral or oral. Presenting symptoms were non–specific in all patients. The morning (AM) cortisol was less than or equal to 5mcg/dl in 21 patients and above 5 mcg /dl upto 7.5 mcg /dl in 8 patients. Mean serum cortisol was 3.28 mcg /dl (SD=2.52), median value of 2.49 mcg /dl. Conclusion: Secondary adrenal insufficiency due to misuse of corticosteroids has a non–specific presentation and we need to consider it in the differential diagnosis of every critically ill patient.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

SECONDARY ADRENAL INSUFFICIENCY DUE TO THE ABUSE OF SYSTEMIC CORTICOSTEROIDS-A GROWING MENACE IN THE ELDERLY- A RETROSPECTIVE STUDY, Dr. Betsy Mathew, Dr. Geetha Ann Francis, Ms. Sumithra Selvam INDIAN JOURNAL OF APPLIED RESEARCH : Volume-9 | Issue-6 | June-2019

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