A 39 yearold woman comes to the clinic complaining of diarrhea and abdominal pain. “I feel so weak.” She reports having four to five loose, occasionally bloody stools per day for the past two weeks, with abdominal cramping beginning over the past 48 hours. She has been self-treating with occasional other-the-counter (OTC) antidiarrheals without success. She denies recent antibiotic use. She complains of severe fatigue. She gave birth to her third child 6 weeks ago. She is not breast feeding.
A complete blood count, blood chemistry (including electrolytes, renal function tests and blood glucose) and serum iron is ordered along with stool cultures, colonoscopy and upper gastrointestinal (UGI) endoscopy with small bowel follow-through.
Lab Data:
| Sodium | 140 mmol/L |
| Potassium | 3.5 mmol/L |
| Chloride | 105 mmol/L |
| Urea | 3.57 mmol/L |
| Serum creatinine | 115 µmol/L |
| Glucose | 7.8 mmol/L |
| Iron | 4.3 µmol/L |
| Hb | 132 g/L |
| Hct | 0.39 L/L |
| WBC | 7.68 x 109 with normal differential |
She is diagnosed with Crohn’s disease and prescribed prednisone 40 mg PO daily for one week, then prednsione 35 mg PO daily for one week. The dosage will be tapered slowly by 5 mg per week until she is receiving 5 mg/day for one week and then the drug will be completely discontinued.
How does prednisone work to address this patient’s pathologic condition?
Step by step
Solved in 3 steps
