Author/Authors :
Hiraiwa, Tetsuya Osaka Medical College - Department of Medicine, Japan , Furutama, Daisuke Osaka Medical College - First Department of Medicine, Japan , Sakane, Sadaki Hirakata City Hospital - Department of Medicine, Japan , Ito, Mitsuru Osaka Medical College - Department of Medicine, Japan , Imagawa, Akihisa Osaka Medical College - Department of Medicine, Japan , Kimura, Fumiharu Osaka Medical College - Department of Medicine, Japan , Hanafusa, Toshiaki Osaka Medical College - Department of Medicine, Japan
Abstract :
Objective: It was the aim of this study to describe a patient with isolated adrenocorticotropic hormone deficiency presenting with a variety of involuntary movements who developed an adrenal crisis due to transient thyroiditis. Clinical Presentation and Intervention: A 61-year-old man was hospitalized with a variety of involuntary movements that were suspected manifestations of metabolic encephalopathy. After admission, his general status rapidly deteriorated to a life-threatening condition that included a degree of hyponatremia. The hyponatremia and metabolic encephalopathy provided clues toward a definitive diagnosis. After corticosteroid and sodium supplementation improved the status of the patient, endocrinological examinations revealed that he suffered from isolated adrenocorticotropic hormone deficiency followed by transient thyroiditis that induced an adrenal crisis. Conclusion: This case emphasizes the importance of considering hypoadrenalism when encountering hyponatremia or metabolic encephalopathy of unknown etiology.
Keywords :
Isolated adrenocorticotropic hormone deficiency , Metabolic encephalopathy , Transient thyroiditis , Adrenal crisis , Hyponatremia
