Authors

GULHAN KANAT UNLER1, HUSEYIN SAVAS GOKTURK1, GULSUM TEKE OZGUR2, TURHAN TOGAN3

Departments

1Baskent University Faculty of Medicine, Department of Gastroenterology, Konya, Turkey - 2Baskent University Faculty of Medicine, Department of Family Medicine, Konya, Turkey - 3Baskent University Faculty of Medicine, Department of Infectious Disease, Konya, Turkey

Abstract

Introduction: Cortisol, which is released from the adrenal cortex, is a steroid hormone with vital functions. Its daily release is regulated by the hypothalamic-hypophyseal-adrenal axis. In healthy people, an adequate amount of endogenous corticosteroids is synthesized in the adrenal gland in response to stressful events, but in patients with adrenal insufficiency, there is a steroid synthesis defect that prevents the patient’s requirements from being met. It may be challenging to diagnose corticosteroid deficiency in some circumstances, which can lead to catastrophic consequences, including death.

Case presentation: In this article, we report a patient who had been using prednisolone 5mg/day for 10 years for rheumatoid arthritis with acute gastroenteritis whose clinical condition deteriorated despite appropriate therapy for 1 week and who was subse- quently diagnosed with secondary adrenal insufficiency.

Conclusion: On the basis of this case report, we remind clinicians of the necessity of rearranging steroid therapy during the course of an infectious disease in patients previously treated with prolonged steroid therapy.

Keywords

Cortisol, Addison crisis, Infection, Gastroenteritis

DOI:

10.19193/0393-6384_2016_2_65