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Life-threatening hypercalcaemia in association with Addisonian crisis
J Miell1, W Wassif, A McGregor
1Department of Medicine, King's College Hospital School of Medicine, London, UK.
Postgraduate Medical Journal
|August 1, 1991
Summary
A patient with hypothyroidism experienced a severe Addisonian crisis and hypercalcaemia after starting thyroxine replacement. This case underscores the need to consider Addison
Area of Science:
- Endocrinology
- Internal Medicine
Background:
- A 35-year-old woman presented with acute radial artery occlusion.
- Initial treatment included surgical intervention and thrombolysis.
Observation:
- Following treatment, primary hypothyroidism was diagnosed and thyroxine replacement initiated.
- The patient's condition deteriorated, leading to an Addisonian crisis.
- Severe, life-threatening hypercalcaemia complicated the crisis.
Findings:
- The case highlights a critical diagnostic challenge in endocrinology.
- It emphasizes the importance of considering Addison's disease in patients with deteriorating conditions post-thyroxine initiation.
Implications:
- This case illustrates a frequently overlooked association between hypercalcaemia and hypoadrenalism.
- Prompt recognition and management of hypoadrenalism are crucial in patients with unexplained deterioration during thyroxine therapy.