Mr. N.V.T, 60 years old, in Ho Chi Minh City, has suffered from leg pain for many years and often used painkillers without knowing that the medicine he used contained corticosteroids - a type of medicine that requires a doctor's prescription and monitoring.
Recently, although the leg pain did not improve much, Mr. T. had another leg infection. When he went to the doctor, he was diagnosed with Cushing's syndrome, an endocrine disease, and acute adrenal insufficiency.
According to Mr. T., not only did he suffer from Cushing's syndrome and adrenal insufficiency, but he also suffered from impaired kidney function, causing fluid retention and acute kidney injury. Corticosteroid abuse is not a new problem, as hospitals receive similar cases every day. However, the situation of adrenal insufficiency due to drug abuse is becoming increasingly alarming.
Dr. Tran Viet Thang, Deputy Head of the Department of Endocrinology at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, said that although the adrenal glands are small, they play a very important role in regulating immunity and the body's response to stress. Adrenal insufficiency occurs when the adrenal glands do not produce enough hormones needed to help the body cope with stress. Adrenal insufficiency is divided into two types: primary and drug-induced. Primary adrenal insufficiency occurs when the adrenal glands are destroyed or due to autoimmune disease. Meanwhile, drug-induced adrenal insufficiency is more common, especially when patients use drugs that inhibit cortisol production for a long time.
Symptoms of adrenal insufficiency vary from patient to patient, but common signs include fatigue, loss of appetite, abdominal pain, and nausea. In severe cases, patients may experience low blood pressure, fever, and impaired consciousness. Patients with adrenal insufficiency due to corticosteroids often have round faces, stretch marks, and fat distribution disorders, concentrated in the abdomen but atrophied in the limbs, making the body weak and emaciated.
For patients with primary adrenal insufficiency, in addition to the above symptoms, they also have dark skin due to increased pigmentation in the mucous membranes of the hands, mouth, and lips. In Vietnam and Southeast Asian countries, adrenal insufficiency due to corticosteroids is quite common because the use of drugs is not strictly controlled.
Dr. Tran Viet Thang explained that when external corticosteroids enter the body, they will inhibit the pituitary gland - which secretes the hormone ACTH, which regulates the production of cortisol in the adrenal glands. When the adrenal glands are inhibited for a long time, they will stop working and shrink. This leads to a high risk of adrenal insufficiency when patients suddenly stop taking corticosteroids.
Long-term use of corticosteroids not only causes changes in body shape, but also leads to complications such as osteoporosis, reduced immune response, increased blood pressure, blood sugar and hypokalemia. The most dangerous risk is adrenal insufficiency.
Treatment of drug-induced adrenal insufficiency involves replacing the deficient hormone and managing any associated medical conditions. Recovery of the adrenal glands depends on the extent of damage and the health status of each patient.
