A Bulking Agent May Lead to Adrenal Insufficiency Crisis: A Case Report

Adrenal insufficiency is a life-threatening disorder which must be treated with glucocorticoid replacement and needs permanent dose adjustment during patient's different somatic situations. Insufficient glucocorticoid doses result in adrenal crisis and must be treated with intravenous hydrocort...

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Bibliographic Details
Main Authors: Seyed Hossein Samadanifard, Farbod Sedaghat-Hamedani, Elham Kayvanpour, Majid Esmaeilzadeh, Salma Ahi
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2011-10-01
Series:Acta Medica Iranica
Subjects:
Online Access:http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/19485.pdf&manuscript_id=19485
Description
Summary:Adrenal insufficiency is a life-threatening disorder which must be treated with glucocorticoid replacement and needs permanent dose adjustment during patient's different somatic situations. Insufficient glucocorticoid doses result in adrenal crisis and must be treated with intravenous hydrocortisone. The patient was known with Adrenal insufficiency and was treated optimally with fludrocortisone and prednisolone since seven years with no history of adrenal crisis. The patient was admitted with abdominal pain, weakness, fatigue and nausea developed 3-4 days after taking psyllium, a bulking agent, prescribed by a surgeon to diagnose anal fissure. Detailed medical history, physical examinations, laboratory and imaging examinations did not approve any other cause of adrenal crisis. Psyllium may interfere with gastrointestinal absorption of prednisolone and/or fludrocortisone and trigger acute adrenal crisis in patients with adrenal insufficiency.
ISSN:0044-6025
0173-5969