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Fast Clinical, but Long-Term, Biochemical Remission after Waterhouse-Friderichsen Syndrome
1Department of Internal Medicine II, Division of Endocrinology and Metabolism, Rainweg 68, Saalfeld 07318, Germany.
Case Reports in Endocrinology
|February 5, 2021
Summary
Waterhouse-Friderichsen Syndrome survivors may regain adrenal function. While clinical recovery can be rapid, full biochemical remission of adrenal insufficiency may take up to five years.
Area of Science:
- Endocrinology
- Infectious Diseases
- Critical Care Medicine
Background:
- Waterhouse-Friderichsen Syndrome (WFS) is a severe bacterial meningitis complication.
- Intravascular coagulopathy in WFS leads to adrenal hemorrhage and primary adrenal insufficiency.
- Limited data exist on adrenal insufficiency recovery in WFS survivors.
Observation:
- A 45-year-old male survived WFS after intensive care.
- He developed primary adrenal insufficiency, confirmed by ACTH stimulation tests.
- Hormone replacement therapy was gradually withdrawn over nine months.
Findings:
- The patient achieved clinical remission relatively quickly.
- Biochemical recovery of adrenal function, indicated by cortisol response, showed gradual improvement.
- Full normalization of cortisol levels after ACTH stimulation took approximately five years.
Implications:
- Clinical remission of WFS does not always equate to immediate biochemical recovery.
- Complete biochemical remission of adrenal insufficiency is possible in WFS survivors.
- Long-term monitoring is crucial for assessing the full recovery timeline of adrenal function.
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