Adrenal insufficiency following use of steroids

[Patricia56]

This study of 59 children with IBD found that up to 20% developed adrenal suppression following use of steroids despite tapering the dose. They found an association between length and dose of steroids and with previous use of steroids and low cortisol levels. They believe that their results underestimate the prevalence of adrenal insufficiency due to the manner of the testing that they used to measure cortisol levels.

The authors recommend that all children who have been on steroid treatment for as little as 2 weeks be checked for adrenal insufficiency before stopping steroids completely.

http://www.biomedcentral.com/1471-230X/14/51

FYI Adrenal insufficiency can be life threatening if the patient develops adrenal crisis in response to a medical emergency such as trauma or severe illness like the flu.

Clinical signs and symptoms of adrenal insufficiency ... can include severe fatigue and weakness, loss of weight, increased pigmentation of the skin, faintness and low blood pressure, often with a particular drop in blood pressure shortly after standing up. Other symptoms include nausea, vomiting, salt craving and painful muscles and joints.

... signs of possible adrenal crisis (typically, persistent vomiting with
profound muscle weakness, low blood pressure or even shock, extreme sleepiness or even coma)

excerpted from Society for Endocinrology patient leaflet

http://www.endocrinology.org/policy/docs/11-03_adrenal insufficiency.pdf

 

[AZMOM]

Patricia - In a twist of irony, my mother in law darn near died from adrenal insufficiency and HIT. She doesn't have IBD.

She had a textbook hip replacement and started getting violently ill after every lovenox injection at home. My father in law took her to the hospital and they attributed her initial vomiting to a post-op ileus and proceeded to working on decompressing her bowel. Then, they discovered a blood clot. Then they started her on heparin and she started going down the tubes.....literally. Bleeding under the skin, semi conscious, platelets bottomed out, etc. etc. Astute doc realized she had HIT - Heparin Induced Thrombocytopenia. That was a new one for me.

As she began to recover, astute doc #2 discovered that she had literally had lost all adrenal function. The acute adrenal failure was likely what was causing the vomiting, inability to stay awake, etc. etc. etc. but the HIT confused the clinical picture. She remains on steroids to this day.....low dose but they cannot wean her since she has no adrenal function.

I was fascinated (and of course my worry gene kicked in :ybatty by your post. Thanks for sharing. I hadn't thought about the adrenal piece in such a long time but we were all consumed when she was ill 3 years ago.

:thumright:

J.