Treatable Bedridden Elderly -Recovery from Flexion Contracture after Cortisol Replacement in a Patient with Isolated Adrenocorticotropic Hormone Deficiency

Intern Med. 2016;55(20):2975-2978. doi: 10.2169/internalmedicine.55.6932. Epub 2016 Oct 15.

Abstract

Isolated adrenocorticotropic hormone deficiency (IAD) is a rare disorder with diverse clinical presentations. A 79-year-old man was bedridden for six months due to flexion contractures of the bilateral hips and knees, along with hyponatremia. He was diagnosed with IAD based on the results of endocrine tests. After one month of corticosteroid replacement, he recovered and was able to stand up by himself. Although flexion contracture is a rare symptom of IAD, steroid replacement therapy may be effective, even for seemingly irreversibly bedridden elderly patients. In bedridden elderly patients with flexion contractures, we should consider and look for any signs of adrenal insufficiency.

Publication types

  • Case Reports

MeSH terms

  • Adrenocorticotropic Hormone / deficiency*
  • Aged
  • Anti-Inflammatory Agents / therapeutic use*
  • Contracture / drug therapy*
  • Contracture / etiology
  • Endocrine System Diseases / complications
  • Endocrine System Diseases / diagnosis*
  • Endocrine System Diseases / drug therapy*
  • Genetic Diseases, Inborn / complications
  • Genetic Diseases, Inborn / diagnosis*
  • Genetic Diseases, Inborn / drug therapy*
  • Humans
  • Hydrocortisone / therapeutic use*
  • Hypoglycemia / complications
  • Hypoglycemia / diagnosis*
  • Hypoglycemia / drug therapy*
  • Hyponatremia / diagnosis
  • Hyponatremia / etiology
  • Leg*
  • Male

Substances

  • Anti-Inflammatory Agents
  • Adrenocorticotropic Hormone
  • Hydrocortisone

Supplementary concepts

  • ACTH Deficiency, Isolated