Insuficiencia suprarrenal secundaria a cirrosis hepática

Abstract

In the present clinical case, a patient of the IESS Riobamba General Teaching Hospital, 68 years old with a history of idiopathic liver cirrhosis, esophageal varices with ligation and high blood pressure in treatment, who initially goes to the emergency service for presenting disorientation plus nausea , anorexia and general discomfort, complementary tests were performed, which are within normal parameters unlike a marked hyponatremia At the time of hospitalization, the patient is suffering from a severe hyponatremia, so that he is admitted to the Internal Medicine service, the correction of electrolyte and antibiotic therapy was initiated without improvement. Endocrinology sends hormonal tests, which are below the allowed parameters, so that they report autoimmune adrenal insufficiency, indicating as daily treatment doses of synthetic corticosteroid (Prednisone), sodium chloride tablets and monthly electrolyte and cortisol control, after this, the patient complies with the proposed treatment, with adequate response, but the use of Hydrocortisone is recommended for a better evolution of his pathology. After 4 months of diagnosis, the patient comes again for the emergency service, for presenting hematemesis of 4 hours of evolution after which he enters hypovolemic shock that could not be compensated and patient dies.