Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 2486  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Article Submission Resources Sections Etcetera Contact
 
  NAVIGATE Here 
 ::   Next article
 ::   Previous article
 ::   Table of Contents

 RESOURCE Links
 ::   Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::Related articles
 ::   Citation Manager
 ::   Access Statistics
 ::   Reader Comments
 ::   Email Alert *
 ::   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed12217    
    Printed309    
    Emailed6    
    PDF Downloaded183    
    Comments [Add]    

Recommend this journal


 

 CASE REPORT
Year : 2003  |  Volume : 49  |  Issue : 1  |  Page : 69-71

Relative adrenal insufficiency in post-transplant lymphoproliferative disorder.


Nephrology Division, Department of Medicine, 4.200 John Sealy Annex, University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas 77555-0562, USA., USA

Correspondence Address:
R D Cinclair
Nephrology Division, Department of Medicine, 4.200 John Sealy Annex, University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas 77555-0562, USA.
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0022-3859.925

Rights and Permissions

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.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow