書誌事項
- タイトル別名
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- A Case of Sepsis-induced Adrenal Insufficiency.
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A 24-year-old healthy man was admitted with hemorrhagic shock due to amputation of the bilateral lower limbs. After the first operation on limbs, hyponatremia with sodium wasting and circulatory instability developed on hospital day 2; endocrinological examination showed hypoaldosteronism and subsequently positive left femoral open-wound culturing followed by a persistent septic state. The absolute low value of cortisol and weak response to the rapid ACTH test helped us to diagnose absolute adrenal insufficiency (AI). Refractory hyperdynamic shock was promptly reversed by treatment with intravenous hydrocortisone and we debrided and surgically closed the left femoral openwound that was the source of sepsis. Several authors have shown that serum cortisol concentration is usually high and absolute AI is rare in sepsis. Due to the lack of specific signs and symptoms in AI, it is difficult to distinguish it from septic shock. Our experience shows the utility of endocrinological examination, including rapid ACTH and CRH tests in the diagnosis of sepsis-induced AI and their results show that AI in septic patients appears to be related to both primary and secondary failure.
収録刊行物
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- 日本救急医学会雑誌
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日本救急医学会雑誌 13 (11), 732-738, 2002
一般社団法人 日本救急医学会
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詳細情報 詳細情報について
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- CRID
- 1390001204371026688
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- NII論文ID
- 130003625853
- 10010217417
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- NII書誌ID
- AN10284604
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- ISSN
- 18833772
- 0915924X
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
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- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可