弁膜症術後に ACTH 単独欠損症が判明した1症例

佐藤 愛子; 穴井 博文; 和田 朋之; 濱本 浩嗣; 嶋岡 徹; 首藤 敬史; 坂口 健; 後藤 孔郎; 吉松 博信; 宮本 伸二

doi:10.4326/jjcvs.39.187

Case Reports

A Case of Adrenocorticotropic Hormone Deficiency after Surgery for Cardiac Valvular Disease

Aiko Sato, Hirofumi Anai, Tomoyuki Wada, Hirotsugu Hamamoto, Toru Shimaoka, Takashi Shuto, Takeshi Sakaguchi, Koro Goto, Hironobu Yoshimatsu, Shinji Miyamoto

Author information

Aiko Sato
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University
Hirofumi Anai
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University
Tomoyuki Wada
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University
Hirotsugu Hamamoto
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University
Toru Shimaoka
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University
Takashi Shuto
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University
Takeshi Sakaguchi
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University
Koro Goto
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University
Hironobu Yoshimatsu
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University
Shinji Miyamoto
Department of Cardiovascular Surgery, First Department of Internal Medicine, Faculty of Medicine, Oita University

Keywords: cardiac valvular disease, adrenocorticotropic hormone deficiency, hypoglycemia, hypotension

JOURNAL FREE ACCESS

2010 Volume 39 Issue 4 Pages 187-190

DOI https://doi.org/10.4326/jjcvs.39.187

Details

Abstract

A 59-year-old man was admitted to our hospital with severe mitral incompetence. Mitral valve repair, tricuspid annuloplasty and the Maze procedure were performed. After weaning from cardiopulmonary bypass, his systolic blood pressure (SBP) dropped to 40 mmHg. Immediate administration of catecholamines markedly increased SBP but his continuing low blood pressure required additional treatment with vasopressin and hydrocortisone. On postoperative day 12 in the general ward, he suddenly lapsed into an intractable hypoglycemic coma. Endocrine function tests revealed adrenocorticotropic hormone deficiency. Since the time of writing has been doing well with 20 mg of hydrocortisone.

Corresponding author

Register with J-STAGE for free!