Annals of Case Reports and Clinical Studies (ISSN: 2834-5673) | Volume 2, Issue 2 | Case Report | Open Access
Tamer Shalaby Boutrus*
Critical care unit, The View Hospital, Doha, Qatar
*Correspondence to: Tamer Shalaby Boutrus
Fulltext PDFWe present a case of tertiary adrenal insufficiency following a prolonged intermittent course of potent steroid cream for a difficult case of eczema. The patient presented to a teaching hospital with recurrent transient loss of consciousness, hypoglycaemia, and sepsis from pneumonia. Intravenous antibiotics and aggressive intravenous fluid were given, CT chest confirmed bronchopneumonia and tuberculosis (TB) was ruled out. Transient loss of consciousness and mild hypoglycaemia (3.2 mmol/L) was felt to be secondary to intravascular depletion from sepsis and the patient was discharged home after four days of intravenous treatment with a plan to continue the course of oral antibiotics to complete seven days of treatment in total. The patient had poor recovery at home with ongoing loss of appetite and energy, recurrent transient loss of consciousness mainly after meals, no seizure activity was noted, and rapid recovery within seconds was followed in each episode. Follow up appointment in clinic noted postural drop in blood pressure with normal renal function and electrolytes, 9 am cortisol was checked and with a very low 68 nmol/L result. This case highlights the importance of expecting true or relative cortisol deficiency in acutely unwell patients who present with syncope and hypoglycaemia in the absence of other common causes of transient loss of consciousness.
Steroid; Serum Cortisol; Young Man
Nehmat Ahmad, Tamer Shalaby Boutrus. Case Study on the Impact of Prolonged Use of Steroid Cream on Serum Cortisol in a Young Man. Ann Case Rep Clin Stud. 2023;2(2):1-5.