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Insuficiencia suprarrenal con presentación de psicosis
Santosha Mantha1, Sachin Modi1, Shilika Lalwani1
1Endocrinology, Army Hospital Research and Referral, New Delhi, India.
BMJ case reports
|December 19, 2025
Resumen
La insuficiencia suprarrenal primaria (ISP) puede manifestarse con síntomas psiquiátricos inusuales como la catatonia. El reconocimiento temprano de los síntomas de la ISP, incluida la hiperpigmentación, ayuda al diagnóstico y tratamiento rápidos.
Área de la Ciencia:
- Endocrinología; Neuropsiquiatría
Sus antecedentes:
- La insuficiencia suprarrenal primaria (ISP) típicamente se presenta con síntomas inespecíficos.; Las manifestaciones neuropsiquiátricas como psicosis y catatonia son raras en la ISP y a menudo se diagnostican erróneamente.
Objetivo del estudio:
- Destacar la presentación neuropsiquiátrica infrecuente de la ISP.; Enfatizar la importancia de reconocer signos clínicos sutiles para un diagnóstico temprano.
Principales métodos:
- Informe de caso de un hombre adulto joven con síntomas psiquiátricos graves.; Examen clínico que revela hiperpigmentación, hipotensión y desequilibrio electrolítico.; Pruebas endocrinas que confirman la ISP autoinmune.
Principales resultados:
- El paciente presentó alucinaciones, delirios y catatonia, junto con problemas gastrointestinales y pérdida de peso.; Los hallazgos de laboratorio indicaron hiponatremia e hiperpotasemia.; La terapia de reemplazo hormonal resultó en una rápida mejora de los síntomas psiquiátricos y físicos.
Conclusiones:
- La ISP debe considerarse en presentaciones psiquiátricas, especialmente cuando se acompaña de signos físicos como hiperpigmentación y pérdida de peso.; La evaluación endocrina rápida puede prevenir el diagnóstico erróneo y las investigaciones innecesarias.; El reemplazo oportuno de corticosteroides y mineralocorticoides es crucial para el manejo de la ISP.
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