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http://dspace.mediu.edu.my:8181/xmlui/handle/123456789/4446| Title: | Relative adrenal insufficiency in post-transplant lymphoproliferative disorder. |
| Keywords: | Adrenal Gland Hypofunction drug therapy etiology Anti-Inflammatory Agents Steroidal therapeutic use Case Report Corticotropin diagnostic use Glucocorticoids pharmacology Human Hyponatremia etiology Hypotension Orthostatic etiology Immunosuppressive Agents pharmacology Kidney Transplantation adverse effects immunology Lymphoproliferative Disorders complications etiology Male Middle Age Prednisone therapeutic use |
| Issue Date: | 30-May-2013 |
| Publisher: | Medknow Publications |
| Description: | Post-transplant lymphoproliferative disorder is treated with rapid decrement of immunosuppressive therapy. This cannot be achieved with ease in patients on long-term glucocorticoid therapy, as chronically suppressed adrenal glands may not be capable of mounting adequate response to stress. A 52-year-old Caucasian male presented with fever, orthostatic hypotension, lymphadenopathy and hyponatraemia. Serum cortisol levels were within normal levels with a sub optimal response to stimulation by ACTH. Hyponatraemia and orthostasis responded poorly to fluid restriction, saline and salt repletion but corrected after increasing the steroid dose. The normal baseline cortisol levels represented a stimulated adrenal gland, however, the ACTH stimulation had inadequate response. This sub optimal stimulation and a good response to increased steroids suggest the presence of relative or occult adrenal insufficiency. Relative adrenal insufficiency must be considered in patients who have received prolonged glucocorticoid therapy and have symptoms such as hypotension and/or hyponatraemia. |
| URI: | http://koha.mediu.edu.my:8181/jspui/handle/123456789/4446 |
| Other Identifiers: | http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=69;epage=71;aulast=Cinclair http://www.doaj.org/doaj?func=openurl&genre=article&issn=00223859&date=2003&volume=49&issue=1&spage=69 |
| Appears in Collections: | Health Sciences |
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