ABSTRACT

A thirty-six-year old female with shock was found to be unconsciousness a few days after developing arespiratory infection. Her past medical history included autoimmune hypothyroidism. Her state of shock was not controlled by massive fluid resuscitation with a vasopressor and antibiotics. However, an infusion of 250 mg methylprednisolone dramatically improved her shock state. Further examination indicated secondary acute adrenal insufficiency. Adrenal insufficiency may complicate other endocrine disorders. Accordingly, a physician should consider hypoadrenocorticism, when patients are in a state of refractory shock in spite of massive infusion with a vasopressor, especially in patients with other endocrine disorders.