Opioid-induced secondary adrenal insufficiency presenting as hypercalcaemia.

摘要: Adrenal insufficiency is a rare cause of hypercalcaemia and should be considered when more common causes such as primary hyperparathyroidism malignancy are excluded. Opioid therapy adrenal possibly under-recognised endocrinopathy with potentially life-threatening adverse effects. We report on case opioid-induced secondary presenting hypercalcaemia. The patient was 25-year-old man who developed during the recovery stage after period critical illness. Systematic investigation his found it to due insufficiency, developing consequence methadone opioid analgesia. Treatment i.v. saline subsequent glucocorticoid replacement led resolution hypoadrenalism resolved opioids were subsequently weaned ceased. These two interacting endocrinopathies consequent highlight importance maintaining awareness serious clinical outcomes which can occur result opioids, particularly considering that symptoms overlap those concomitant hydration effective in promptly resolving hypoadrenalism. Hypoadrenalism prescribed recreational may than currently recognised. Learning points Opioid clinically significant this recognised. Adrenal reversible discontinuation therapy. Hypercalcaemia feature. Treatment involves replacement.