Steroid Withdrawal Syndrome in Salted Fish Seller with Rheumatoid Arthritis: A Case Report

Abstract

Background: Traditional and complementary medicine (TCM) is often seen as the more accessible and affordable version of medicine. One of the most commonly found substances in TCM is steroids, which can alleviate pain. However, long-term usage of steroids may cause several adverse effects, and an abrupt cessation can cause steroid withdrawal syndrome. This case report discusses the relationship between a patient who worked as a salted fish seller with the diagnosis of steroid withdrawal syndrome.

Case Presentation: A 43-year-old man worked as a salted fish seller and encountered various potential hazards. He had been diagnosed with rheumatoid arthritis for 2 years and consumed a steroid-containing-TCM daily. He ceased the TCM consumption and started experiencing generalised weakness, nausea, dizziness, swollen feet, and weight loss. Upon further examination, the patient was diagnosed with a steroid withdrawal syndrome.

Discussion: There are seven steps required to establish the diagnosis of an occupational disease. In this case, it was found that the leading cause of steroid withdrawal syndrome is the sudden cessation of long-term improper usage of steroids.

Conclusion: The occupational exposures of a salted fish seller are not proven to cause or exacerbate the steroid withdrawal syndrome experienced by the patient.