Atypical presentation of shock from acute adrenal insufficiency in an adolescent male. Pediatr Emerg Care 2005 Jun;21(6):380-3
Date
06/09/2005Pubmed ID
15942517DOI
10.1097/01.pec.0000166730.63223.b2Scopus ID
2-s2.0-20544475271 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
OBJECTIVE: To report an atypical presentation of shock and acute adrenal insufficiency in an adolescent male.
CASE SUMMARY: A 14-year-old boy with a history of nocturnal enuresis presented with a clinical picture suggestive of septic shock refractory to aggressive fluid and vasopressor management. History and physical examination were suggestive of shock secondary to an infectious etiology, associated with skin findings of hyperpigmentation. The laboratory studies were remarkable for normal sodium, potassium, glucose, as well as normal renin levels. Hydrocortisone therapy led to improvement of his blood pressure and allowed weaning of vasopressor medications. Further laboratory studies, including adrenocorticotropic hormone stimulation test and adrenal antibodies, confirmed the diagnosis of primary adrenal insufficiency.
CONCLUSION: Acute adrenal insufficiency is an uncommon cause of shock in the adolescent population. We report a clinical presentation suggestive of shock secondary to acute adrenal insufficiency remarkable for an atypical clinical and laboratory presentation. We further provide information on the management of acute adrenal crisis.
Author List
Kwok MY, Scanlon MC, Slyper AHAuthor
Matthew C. Scanlon MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute DiseaseAddison Disease
Adolescent
Emergency Medicine
Glucocorticoids
Humans
Hydrocortisone
Hyperpigmentation
Male
Shock
Vasoconstrictor Agents
