A
Here is a concise bullet-point gist of the article:
-
Rare but serious: Pediatric adrenal insufficiency is uncommon and easily overlooked, but delayed diagnosis can be fatal.
-
Variable presentations: Two adolescents presented with similar symptoms (asthenia, anorexia, GI complaints, hyperpigmentation) but differed in severity—one in Addisonian crisis, the other stable.
-
Classic lab pattern: Both showed hyponatremia, hyperkalemia, hypoglycemia, low cortisol/aldosterone, and high ACTH/renin, confirming primary adrenal insufficiency (Addison’s disease).
-
Autoimmune cause identified: Both had adrenal antibodies; one also had Hashimoto’s Thyroiditis, establishing Autoimmune Polyglandular Syndrome type 2 (APS2)—exceedingly rare in childhood.
-
Urgent management essential: Crisis requires immediate fluids and IV hydrocortisone; long-term treatment includes oral hydrocortisone + fludrocortisone, with stress-dose adjustments.
-
Key message: High clinical suspicion is crucial—nonspecific symptoms + hyperpigmentation should prompt evaluation for adrenal insufficiency and associated autoimmune diseases.
Hyperpigmentation of the fingers (Dorsal Surface).
No comments:
Post a Comment