Abstract
This is the first reported case of survival of a significant burn in a patient with established Addison's disease. The systemic stress response to thermal injury is well recognised, there is a marked hypermetabolic response with prolonged periods of catabolism. In particular, the elevation of plasma cortisol levels is crucial for this response to severe systemic stress. Cortisol elevation is maintained for the duration of burn wound healing, is proportional to the burned body surface area and the normal circadian rhythm of endogenous cortisol is lost. Acute adrenal insufficiency has been described in patients suffering major burn injuries with generally poor outcomes. We discuss the management and complications of adrenal replacement therapy in a severe burn setting, as illustrated by this case report.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 391-393 |
| Number of pages | 3 |
| Journal | Burns |
| Volume | 28 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jun 22 2002 |
| Externally published | Yes |
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Keywords
- Addison's
- Adrenal
- Burn
- Cortisol
ASJC Scopus subject areas
- Surgery
- Emergency Medicine
- Critical Care and Intensive Care Medicine
Cite this
Survival of a 75% burn in a patient with longstanding Addison's disease. / James, S. E.; Ghosh, S. J.; Montgomerie, J.; Philp, B. M.; Dziewulski, Peter.
In: Burns, Vol. 28, No. 4, 22.06.2002, p. 391-393.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Survival of a 75% burn in a patient with longstanding Addison's disease
AU - James, S. E.
AU - Ghosh, S. J.
AU - Montgomerie, J.
AU - Philp, B. M.
AU - Dziewulski, Peter
PY - 2002/6/22
Y1 - 2002/6/22
N2 - This is the first reported case of survival of a significant burn in a patient with established Addison's disease. The systemic stress response to thermal injury is well recognised, there is a marked hypermetabolic response with prolonged periods of catabolism. In particular, the elevation of plasma cortisol levels is crucial for this response to severe systemic stress. Cortisol elevation is maintained for the duration of burn wound healing, is proportional to the burned body surface area and the normal circadian rhythm of endogenous cortisol is lost. Acute adrenal insufficiency has been described in patients suffering major burn injuries with generally poor outcomes. We discuss the management and complications of adrenal replacement therapy in a severe burn setting, as illustrated by this case report.
AB - This is the first reported case of survival of a significant burn in a patient with established Addison's disease. The systemic stress response to thermal injury is well recognised, there is a marked hypermetabolic response with prolonged periods of catabolism. In particular, the elevation of plasma cortisol levels is crucial for this response to severe systemic stress. Cortisol elevation is maintained for the duration of burn wound healing, is proportional to the burned body surface area and the normal circadian rhythm of endogenous cortisol is lost. Acute adrenal insufficiency has been described in patients suffering major burn injuries with generally poor outcomes. We discuss the management and complications of adrenal replacement therapy in a severe burn setting, as illustrated by this case report.
KW - Addison's
KW - Adrenal
KW - Burn
KW - Cortisol
UR - http://www.scopus.com/inward/record.url?scp=0036281194&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036281194&partnerID=8YFLogxK
U2 - 10.1016/S0305-4179(02)00014-1
DO - 10.1016/S0305-4179(02)00014-1
M3 - Article
VL - 28
SP - 391
EP - 393
JO - Burns
JF - Burns
SN - 0305-4179
IS - 4
ER -