Hello people. My mother was diagnosed with GCA last August, she is now on 8 mg daily, the last few days she has been unwell, symptoms include vomiting and extreme fatigue ( sleeping roughy 22 hrs per day ) her GP today diagnosed a chest infection I however am dubious, and wonder if it is the Prednisolone affecting her ATCH levels which in turn would affect her Cortisol levels and produce symptoms that would more match her current state than a chest infection would. Does anyone have any experience of this, any advice/observations would be gratefully received. Thank You B
Eu não sei mais do que o que li aqui e ali. Que tipo de infecção no peito o médico acha que ela tem? Viral? Bacteriana? Ela tem febre alta? Eu poderia ver uma febre alta causando náuseas e fadiga, suponho. Você perguntou ao médico da sua mãe sobre sua preocupação. Há quanto tempo sua mãe está tomando 8 mg? Eu imaginaria que, se for uma redução recente para 8, eu suspeitaria de insuficiência adrenal. Por outro lado, se ela estiver sob algum estresse incomum, isso teria exigido mais cortisol do que ela pode estar produzindo? Uma doença poderia fazer isso, suponho. Acho que estou pensando enquanto digito que talvez ela tenha uma "infecção no peito", mas os vômitos e a fadiga poderiam ser uma insuficiência adrenal parcialmente causada pela necessidade do corpo de lidar com a infecção no peito.
Eu gostaria de ter a base de conhecimento para lhe dar mais expertise.
If your mother had CGA, she must have been on high dose of prednisone. Her adrenal glands are most likely not active and not producing any cortisol due to long treatment with prednisone. The only cortisol in her body is the one from prednisone. Any infection would create aditional inflamation and maybe this is causing her extreme fatigue. Best to listen to a doctor and take care of chest infection first, the rest of the symptoms will sort themself out. I am not a doctor, but if you syspect that her cortisol is the reason for symptoms, then it may not hurt to try higher dose for few days. What I read on this site is that usually people add +5mg to existing dose. If you keep it relatively short , less then a week, she does not ahve to taper back down and can directly go back to 8mg or just above that level after a week.
Sua mãe foi diagnosticada apenas em agosto e já está em 8mg????? Em que dose ela começou e como foi a redução???
Ela ainda tem GCA ativa (o que a deixa cansada e fatigada), a dose de pred pode não ser suficiente E ela tem uma infecção - não é à toa que ela não está bem.
The symptoms you describe are typical of an adrenal crisis - quite possible if she has reduced rapidly from a GCA dose to 8mg over such a short time. The pred per se isn't doing it if it is - it is the LACK of pred without her body having started to produce its own corticosteroid again which can take a few months even when it does happen (occasionally it doesn't). After only 7 months it is also quite likely that the GCA could still be active.
How old is she and what dose did she start on last August? Normal would be 40-60mg for GCA - and normal reduction plans in GCA take 2 years or more to get from the starting dose. Most experts would keep GCA patients above 20mg for at least 6 months - a study has shown there are still signs of inflammation even then.
If you go to this post:
https://patient.info/forums/discuss/pmr-gca-website-addresses-and-resources-35316
and scroll down you will find a heading "Bristol paper". That includes recommendations for management of GCA. If your mother's GP won't listen to you, try another in the practice. If no-one listens - a 999 call seems not unreasonable.
Sorry this response is so late - I've only just got the notification.
Hi Barbara, I'm sorry your mum is so unwell, it's a huge worry for you. She may well have a chest infection but I think the issue is the 8mg she's at now. It's possibly too low for her as her adrenal haven't kicked in yet, that coupled with an infection, is causing enormous strain on her system. I would increase her dose, she could go up to a higher dose for 5 days, to a week and then come straight back to the 8mg without tapering and she won't get any withdrawals. Plus in the week she will hopefully have recovered from the chest infection and be better able to cope at 8mg. How long was she at 8mg before she got ill? Once she was at 10mg she needed to taper super slow, in order for her adrenals to start waking up! Please come back and let us know how she's doing! All the best to you both.