Acute Adrenocortical Insufficiency Induced by Abused Steroids in Orthopaedic Patients

Owing to the dramatic effects on human-beings, steroids are commonly used indiscriminately in some developing and under-developed countries. The drugs, usually taken unnoticedly for a long period of time, may result in exogenous Cushing’s syndrome. The most critical problem, however, is suppression of the hypothalamic-pituitary-adrenal axis without any prodromal signs. If the patients is confronted by an unusual stress, acute adrenocortical insufficiency with overwhelming symptoms may occur. Unless diagnosed and treated early, morbidity is very severe and the patient’s life may be jeopardized. This special complication is not uncommon in orthopaedic field and frequently missed. Ten such patients associated with various orthopaedic diseases were studied and compared to normal subjects. The serum cortisol levels of the patients were much lower than those of the control. However, serum cortisol is not the prime determinant of clinical symptoms but a low cortisol level may suggest the possibility of adrenocortical insufficiency and requests and urgent management.

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abused steroids

國際替代計量

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