- 2023, Volume 54 - Number 3
- Published: August 7, 2023
Delayed diagnosis of adrenal insufficiency in a patient with presumed eating disorder
André Morais 1, Lídia Leite 2, Mariana Barbosa 3, Liliana Abreu 4, Filipa Balona 4, Olinda Marques 5, Ana Antunes 5, Maria Miguel-Gomes 2
1 Department of Pediatrics, Hospital de Braga, Braga, Portugal; 2 Pediatric Department, Hospital de Braga, Braga, Portugal; 3 Endocrinology Department, Hospital de Braga, Braga, Portugal; 4 Pediatric Intermediate Care Unit, Hospital de Braga, Braga, Portugal; 5 Pediatric Endocrinology and Diabetology Unit. Hospital de Braga, Braga, Portugal
André Morais, Lídia Leite, Mariana Barbosa, Liliana Abreu, Filipa Balona, Olinda Marques, Ana Antunes, Maria Miguel-Gomes
La información completa de afiliaciones y autor de correspondencia está disponible en la versión original en PDF.
*Correspondence: Ana Antunes, Email not available
Abstract
Adrenal insufficiency (AI) is a rare condition that can be potentially life-threatening and manifests as an endocrine emergency. The authors present the case of a primary AI in a 13-year-old girl, previously followed in a pediatric and psychology consultation due to weight loss and anorexia, with suspected eating disorder. On admission, the patient had moderate dehydration, asthenia and palmar and gingival hyperpigmentation that raised the hypothesis of adrenal insufficiency. Laboratory results confirmed the diagnosis: hyponatremia, hyperkalemia, high adrenocorticotropic hormone (ACTH) and low cortisol levels. Treatment with hydrocortisone and fludrocortisone was started, with favorable response. The nonspecific nature of the presenting symptoms, underlines the importance of a high level of suspicion. AI is a rare diagnosis that can be misdiagnosed or misinterpreted with more frequent diseases such as eating disorders, delaying timely diagnosis and treatment.
