Secondary adrenocortical insufficiency complicated by marked hypercalcemia and eosinophilia: a case report

A 56 year old female was admitted to a local hospital after developing symptoms, including generalized fatigue, nausea and vomiting, from trauma. She was relocated to our hospital because she developed other symptoms, including disturbance of consciousness from hypercalcemia and a rash over her entire body. Her clinical symptoms (disturbance of consciousness, loss of appetite, nausea, vomiting, decrease in blood pressure, fever) and examination findings (low blood cortisol levels (1.2 μg/dl ), hypercalcemia (11.0 mg/dl ), peripheral blood eosinophilia (1,600 /μl )) lead to a diagnosis of adrenal insufficiency. In addition, a skin biopsy indicated eosinophilic infiltration, although her condition improved in the end with an oral dose of 30 mg/day of prednisolone. Hypercalcemia and peripheral blood eosinophilia are commonly known examination findings for adrenocortical insufficiency, but it is rare for either of these to be present as clinical symptoms.