Diana Henao, Diana Romero, Daniela Rosero, Oscar Lucero
Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia.
Pontificia Universidad Javeriana-Hospital Universitario San Ignacio, Bogotá, Colombia.
SAGE Open Med Case Rep. 2023 Jun 19;11:2050313X231181653. doi: 10.1177/2050313X231181653. eCollection 2023.
A 62-year-old man was admitted to the emergency department with hypotension and altered consciousness. On physical examination, he had hyperpigmentation of the skin and mucous membranes. Admission tests revealed hypoglycemia, hyponatremia, and hyperkalemia. Fluid resuscitation was initiated with no improvement in blood pressure. Because adrenal crisis was suspected, blood samples for cortisol and adrenocorticotropic hormone were collected before commencing hydrocortisone, after which blood pressure improved and electrolyte disturbances disappeared. The tests revealed decreased serum cortisol and an increase in adrenocorticotropic hormone. A magnetic resonance imaging scan of the abdomen revealed evidence of bilateral adrenal hemorrhage. Positive antiphospholipid antibodies were detected during the investigations. This case underscores the importance of prompt evaluation of clinical signs and symptoms that may indicate adrenal crisis.
一名62岁男性因低血压和意识改变被收入急诊科。体格检查发现其皮肤和黏膜色素沉着。入院检查显示低血糖、低钠血症和高钾血症。进行了液体复苏，但血压没有改善。由于怀疑是肾上腺危象，在开始使用氢化可的松之前采集了血样检测皮质醇和促肾上腺皮质激素，之后血压改善，电解质紊乱消失。检测显示血清皮质醇降低，促肾上腺皮质激素升高。腹部磁共振成像扫描显示双侧肾上腺出血。在检查过程中检测到抗磷脂抗体阳性。该病例强调了及时评估可能提示肾上腺危象的临床体征和症状的重要性。
