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This article serves as a reminder that trauma can and will precipitate adrenal insufficiency and crisis in those trauma patients who are on steroids pre-injury. Look for prednisone or hydrocortisone as well as autoimmune or rheumatologic diseases on pre-injury medication list and history. Consider the diagnosis in trauma patients with refractory hypotension not responsive to vasopressors. Replacement therapy with hydrocortisone is the therapy.
References
Current Surgery
Volume 62, Issue 6, November–December 2005, Pages 633-637
Relative Adrenal Insufficiency Among Trauma Patients in a Community Hospital
Brian R. Beeman MD ?, Thomas J. Veverka MD †, Phillip Lambert MD ‡, Dennis M. Boysen Md