Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2011-6-9
pubmed:abstractText
Isolated adrenocorticotropic hormone (ACTH) deficiency is an extremely rare disease in which ACTH-producing cells of the pituitary gland are selectively damaged. The resulting decline in ACTH production and secretion results in chronic secondary adrenocortical insufficiency. The patient in this case did not present with adrenal insufficiency symptoms prior to surgery. However, after cardiotomy under extracorporeal circulation, the patient lapsed into a catecholamine-resistant shock and hypoglycemic coma. Acute adrenal insufficiency was strongly suspected, and the patient was diagnosed with isolated ACTH deficiency after careful examination. Because the demand for cortisol increases after highly invasive surgeries, cortisol supplementation therapy is essential for patients with complications from isolated ACTH deficiency. There is a high risk of a lethal outcome when surgery is carried out without a diagnosis, as in this case. Therefore, cortisol must be supplemented without delay when acute adrenal insufficiency is suspected during the perioperative period.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1438-8359
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
25
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
431-4
pubmed:meshHeading
pubmed-meshheading:21400210-Acute Kidney Injury, pubmed-meshheading:21400210-Adrenal Insufficiency, pubmed-meshheading:21400210-Anesthesia, pubmed-meshheading:21400210-Blood Gas Analysis, pubmed-meshheading:21400210-Cardiac Surgical Procedures, pubmed-meshheading:21400210-Cardiopulmonary Bypass, pubmed-meshheading:21400210-Catecholamines, pubmed-meshheading:21400210-Chronic Disease, pubmed-meshheading:21400210-Diabetic Coma, pubmed-meshheading:21400210-Drug Resistance, pubmed-meshheading:21400210-Hemodynamics, pubmed-meshheading:21400210-Humans, pubmed-meshheading:21400210-Hydrocortisone, pubmed-meshheading:21400210-Male, pubmed-meshheading:21400210-Middle Aged, pubmed-meshheading:21400210-Mitral Valve Insufficiency, pubmed-meshheading:21400210-Pituitary Function Tests, pubmed-meshheading:21400210-Postoperative Complications, pubmed-meshheading:21400210-Potassium, pubmed-meshheading:21400210-Preanesthetic Medication, pubmed-meshheading:21400210-Shock, pubmed-meshheading:21400210-Sodium
pubmed:year
2011
pubmed:articleTitle
Catecholamine-resistant shock and hypoglycemic coma after cardiotomy in a patient with unexpected isolated ACTH deficiency.
pubmed:affiliation
Department of Anesthesiology and Intensive Care Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka-Hasamamachi, Yufu, Oita, 879-5593, Japan. sigekiyo@oita-u.ac.jp
pubmed:publicationType
Journal Article, Case Reports