Secondary Adrenocortical Insufficiency in a Geriatric Patient
Authors:
Hana Velanová; Kamila Greplová; Soňa Holešínská
Authors‘ workplace:
Všeobecná interní klinika, Fakultní nemocnice Brno
Published in:
Geriatrie a Gerontologie 2025, 14, č. 2: 80-84
Category:
doi:
https://doi.org/10.61568/geri/50-6499/20250512/140521
Overview
Hypocortical insufficiency (AI) is a condition in which the adrenal cortex does not produce sufficient amounts of hormones, especially cortisol. Gradually developing insufficiency can go unnoticed, especially in the elderly, due to its nonspecific symptoms that can easily be mistaken for other age-related health problems. This case report presents the case of a patient who developed functional hypocorticism after short-term therapy with high doses of glucocorticoids as part of the treatment of covid-19. The patient was repeatedly examined for nonspecific problems including collapse states with hypotension and anorexia with subsequent weight loss. The correct diagnosis was finally revealed by repeated findings of hyponatremia. After starting therapy, the patient‘s condition improved significantly.
Keywords:
adrenocortical insufficiency – glucocorticoids – geriatric – hypocorticism
Sources
1. Češka R. Interna. 3. vyd. Praha: Triton 2020.
2. Kršek M. Diagnostika a diferenciální diagnostika hypokortikalizmu. Interní Med 2014; (16): 119–122.
3. Younes AK, Younes NK. Recovery of steroid induced adrenal insufficiency. Transl Pediatr 2017; 6(4): 26973–26273.
4. Gulanikar A, Patlola A, Aruna G. Determination of HPA axis suppression in patients on systemic steroids in dermatology. IJCED 2024; 10(1): 32–37.
5. Kršek M. Systémová léčba glukokortikoidy: praktický pohled. Vnitř Lék 2015; 61: 905–912.
6. Filippatos T D, Makri A, Elisaf M S, et al. Hyponatremia in the elderly: challenges and solutions. Clin Interv Aging 2017; 12: 1957–1965.
7. De Silva SDN, Aravinthan M, Katulanda P. Glucocorticoid-induced adrenal insufficiency: An uncommon cause of hypercalcaemia. Endocrinol Diabetes Metab Case Rep 2022; 2022: 21–0177.
8. Beuschlein F, Else T, Bancos I, et al. European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and therapy of glucocorticoid-induced adrenal insufficiency. Eur J Endocrinol 2024; 190(5), G25–51.
9. Laugesen K, Jørgensen JOL, Sørensen HT, et al. Systemic glucocorticoid use in Denmark: a population-based prevalence study. BMJ Open 2017; 7(5): e015237.
Labels
Geriatrics General practitioner for adults Orthopaedic prostheticsArticle was published in
Geriatrics and Gerontology
2025 Issue 2
Most read in this issue
- Incidence, risk factors and treatment of non-healing wounds in geriatric patients
- Psychologist in Long-Term Care Facilities: Roles, Specifics, and Challenges for Practice
- Ghrelin. Also interesting for seniors?
- The Life Story Approach in Dementia Care: Paths and Challenges