Ominous triad triggered by high-dose glucocorticosteroid therapy.

Bär, Sarah; Daudel, Fritz; Züger, Thomas (2017). Ominous triad triggered by high-dose glucocorticosteroid therapy. BMJ case reports, 2017 BMJ Publishing Group 10.1136/bcr-2017-220328

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Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy. Our patient's condition was further aggravated by a circulatory shock, haemodynamic relevant bleeding from a duodenal ulcer and psychotic symptoms. In the intensive care unit, intravenous insulin infusion, fluid resuscitation, catecholamine support, electrolyte supplementation, endoscopic haemoclipping and antibiotic and antipsychotic treatment were administered, leading to a continuous improvement of the patient's health state.

Item Type:	Journal Article (Further Contribution)
Division/Institute:	04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care 04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1757-790X
Publisher:	BMJ Publishing Group
Language:	English
Submitter:	Andreas Melmer
Date Deposited:	27 Sep 2019 14:06
Last Modified:	27 Sep 2019 14:06
Publisher DOI:	10.1136/bcr-2017-220328
PubMed ID:	28630246
Uncontrolled Keywords:	Contraindications and precautions Diabetes Lipid disorders Metabolic disorders Pancreatitis
URI:	https://boris.unibe.ch/id/eprint/111479