2023
DOI: 10.7759/cureus.38234
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Adrenal Insufficiency Associated With Empty Sella Syndrome and Steroid Malabsorption Complicated With Septic Shock Due to Post-transplant Pyelonephritis: A Case Report

Abstract: Renal transplant recipients are immunocompromised and predisposed to develop hyponatremia because they are exposed to immunological, infectious, pharmacological, and oncologic disorders. A 61-year-old female renal transplant recipient was admitted with diarrhea, anorexia, and headache for about a week during the tapering of oral methylprednisolone for chronic renal allograft rejection. She also presented hyponatremia and was suspected to have secondary adrenal insufficiency based on a low plasma cortisol level… Show more

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Cited by 2 publications
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“…Recently, numerous case reports have described refractory hypotension and unexplained severe hyponatremia associated with sudden exacerbation/crisis of secondary adrenal insufficiency during periods of stress. All of them occurred in patients with empty sella syndrome and undiagnosed chronic adrenal insufficiency [22][23][24][25][26].…”
Section: Discussionmentioning
confidence: 99%
“…Recently, numerous case reports have described refractory hypotension and unexplained severe hyponatremia associated with sudden exacerbation/crisis of secondary adrenal insufficiency during periods of stress. All of them occurred in patients with empty sella syndrome and undiagnosed chronic adrenal insufficiency [22][23][24][25][26].…”
Section: Discussionmentioning
confidence: 99%
“…We recently reported the case of a 61-year-old woman who was a renal transplant recipient and who was the older sister of the man. The woman complained of diarrhea, anorexia, and headache during oral steroid treatment, causing adrenal insufficiency associated with steroid malabsorption [8]. The family pedigree is shown in Fig.…”
Section: Case Presentationmentioning
confidence: 99%