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Tue Jun 5 15:03:56 BST 2007

Alan,

Perhaps your patients do not have adrenal insufficiency.  It is not that common.  I will guarantee though that when you find a patient with increased eos (unless there is some other zebra causing them) that if you do an adrenal stimulation test it will be abnormal.
john

________________________________

From: trauma-list-bounces at trauma.org on behalf of Tyroch, Alan
Sent: Sat 5/26/2007 4:29 PM
To: Trauma &amp; Critical Care mailing list
Subject: RE: adrenal insufficiency

Although the literature states that there is eosinophilia with adrenal
insufficiency, I personally have never seen it (and I have been looking
for it)in our surgical/trauma patients in the ICU.
A. Tyroch
TTUHSC-El Paso

-----Original Message-----
From: Rangraj Setlur [mailto:rangraj at gmail.com]
Sent: Tuesday, May 22, 2007 9:05 AM
To: Trauma &amp, Critical Care mailing list
Subject: Re: adrenal insufficiency

Dr Hall, thats a fascinating statement. Do you have any references which
back that up? what level of eosinophils would you consider as elevated
in a
setting of sepsis? we do differentials  for eosinophilia in india
because of
tropical eosinophilia, but i'd never thought of looking specifically at
eosinophils in this setting.
thanks,
rangraj

On 5/22/07, Hall, John R <John_R_Hall at wellmont.org> wrote:
>
> An easy way to "check" for adrenal insufficiency is to look at the eos
on
> your WBC.  If the person is "normal", they should be suppressed due to
> adrenal steroids (usually elevated post shock, icu, etc).  If they are
> elevated, it is almost diagnostic for adrenal insufficiency in the ICU
> (barring a few zebras)
> j
>
> ________________________________
>
> From: trauma-list-bounces at trauma.org on behalf of Rangraj Setlur
> Sent: Tue 5/15/2007 9:15 AM
> To: Trauma &amp, Critical Care mailing list
> Subject: Re: adrenal insufficiency
>
>
>
> I'm sure it exists, but theres also the possibility that what being
seen
> is
> vasopressin deficiency.
> rangraj
> On 5/13/07, Roy Danks <roydanks at hotmail.com> wrote:
> >
> > Absolutely...low flow state.  Without a doubt.  well described in
the
> > acute burn patient as well.
> >
> > RD
> >
> >
> >
> > > Date: Sun, 13 May 2007 14:12:31 +0100> From: kazakosgm at yahoo.gr>
To:
> > trauma-list at trauma.org> Subject: adrenal insufficiency> > Dear all,>
I'd
> > like to ask if any of you have ever suspected relative adrenal
> insufficiency
> > after profound hemorrhagic shock (even if you didn't administered
> steroids).
> > Thank you in advance, > George M. Kazakos DVM, PhD.> > > George M.
> Kazakos
> > DVM, PhD, > Anesthesia and Intensive Care Unit, > Companion Animal
> Clinic, >
> > Dept. Clinical Sciences, > Faculty of Veterinary Medicine, >
Aristotle
> > University of Thessaloniki, > 11 St. Voutyra str., > 54627
Thessaloniki,
> >
> > Greece> > ---------------------------------> ?????????????? Yahoo!>
> > ?????????? ?? ?????????? ???? ???? (spam); ?? Yahoo! Mail ????????
???
> > ???????? ?????? ????????? ???? ??? ??????????? ????????? >
> > http://login.yahoo.com/config/mail?.intl=gr > --> trauma-list :
> TRAUMA.ORG>
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>
> --
> Lt Col Rangraj Setlur
> Associate Professor
> Department of Anaesthesiology and Critical Care
> Armed Forces Medical College
> Pune
> India
>
>
>
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--
Lt Col Rangraj Setlur
Associate Professor
Department of Anaesthesiology and Critical Care
Armed Forces Medical College
Pune
India

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