Document Detail


Hydrocortisone improves somnolence without hypotension in the postpartum period.
MedLine Citation:
PMID:  18306013     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypothalamic-pituitary-adrenal (HPA) axis abnormality and adrenal insufficiency secondary to chronic steroid treatment can be present in the perioperative period. When this occurs in pregnant patients during the peripartum period, the usually expected physiological changes may not be present. The hypotension associated with adrenal insufficiency may be masked by the normal physiological changes of pregnancy and delivery. We report on a patient whose only presenting symptom was mental status changes; this occurred without any significant hemodynamic changes. These mental status changes responded within minutes to a single dose of hydrocortisone. We recommend administering a pharmacological dose of steroid as a maneuver to rule out adrenal insufficiency when faced with a patient with an unexplained altered mental status while other differential diagnoses are considered.
Authors:
Nada Usta-Makkaoui; Timothy L Lacy; Neil Roy Connelly
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-02-27
Journal Detail:
Title:  Journal of anesthesia     Volume:  22     ISSN:  0913-8668     ISO Abbreviation:  J Anesth     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-28     Completed Date:  2008-05-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  49-51     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Baystate Medical Center, Springfield, MA 01199, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Insufficiency / diagnosis,  drug therapy*,  etiology
Adult
Diagnosis, Differential
Disorders of Excessive Somnolence / drug therapy*,  etiology
Female
Humans
Hydrocortisone / therapeutic use*
Hypotension
Postpartum Period
Pregnancy
Pregnancy Complications / drug therapy*,  etiology
Treatment Outcome
Chemical
Reg. No./Substance:
50-23-7/Hydrocortisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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