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Hypokalemic adrenal crisis in a patient with AIDS
1Department of Medicine, George Washington University Medical Center, Washington, DC 20037.
Abstract:
Electrolyte disorders have been reported frequently in patients with AIDS. Adrenal insufficiency has been associated with hyponatremia in this group of patients. We have presented the case of a patient with AIDS whose early course was complicated by hyponatremia, hypoglycemia, and hyperkalemia. Shortly thereafter, hypokalemia developed due to gastrointestinal potassium losses from diarrhea. Although cosyntropin stimulation testing later confirmed the diagnosis of adrenal insufficiency, it was not considered because of coexistent hypokalemia. Diarrhea in patients with AIDS and diminished adrenal reserve may invalidate hypokalemia as an exclusion criterion for the diagnosis of adrenal crisis.
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