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Related Experiment Videos

Adrenal crisis presenting as hypoglycemic coma.

J E Fischer1, T Stallmach, S Fanconi

  • 1Department of Intensive Care, Children's Hospital, University of Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Swizerland. jfischer@kispi.unizh.ch

Intensive Care Medicine
|February 9, 2000
PubMed
Summary
This summary is machine-generated.

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An infant experienced hypoglycemic coma and circulatory collapse, initially suspected as septic shock. The cause was isolated ACTH deficiency, highlighting the need to consider adrenal crisis in pediatric hypoglycemia.

Area of Science:

  • Pediatric Endocrinology
  • Critical Care Medicine
  • Endocrinology

Background:

  • Adrenal crisis, a life-threatening condition, can present with non-specific symptoms in infants.
  • Hypoglycemia and circulatory deterioration in non-diabetic children warrant a thorough differential diagnosis.

Observation:

  • An 18-month-old infant presented with hypoglycemic coma and bronchopneumonia, initially treated for septic shock.
  • Despite intensive care, the infant developed irreversible multiple organ failure.
  • Autopsy revealed absent adrenal cortical tissue and pituitary immunohistochemistry confirmed isolated ACTH deficiency.

Findings:

  • Plasma ACTH and cortisol were undetectable, while renin and aldosterone were normal.
  • The absence of adrenal cortical tissue confirmed the diagnosis of isolated ACTH deficiency.

Related Experiment Videos

  • This case highlights a rare cause of adrenal insufficiency in a pediatric patient.

    • Implications:

    • Pediatric intensive care clinicians should consider adrenal crisis in non-diabetic children presenting with hypoglycemia and rapid circulatory deterioration.
    • Early diagnosis and management of adrenal crisis are crucial to prevent fatal outcomes.
    • Isolated ACTH deficiency should be included in the differential diagnosis of unexplained hypoglycemia and shock in children.