Atypical presentation of shock from acute adrenal insufficiency in an adolescent male.

Publication/Presentation Date

6-1-2005

Abstract

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.

Volume

21

Issue

6

First Page

380

Last Page

383

ISSN

1535-1815

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

15942517

Department(s)

Department of Pediatrics

Document Type

Article

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