A 3-year-old girl with Graves' disease with hypoglycemia following transient adrenal hyporesponsiveness.
A 3-year-old girl with Graves' disease developed a generalized convulsion as a result of hypoglycemia (25 mg/dL). At the time of the hypoglycemic seizure, her plasma adrenocorticotropin (ACTH) level (1460 pg/mL) was extremely high, but her serum cortisol level (28.4 microg/dL) was relatively low given the severe stress. The cortisol-releasing hormone (CRH) provocation test done after thyroid function had improved revealed normal ACTH and cortisol responses. Since there was no other cause of hypoglycemia, such as hyperinsulinemia, long-term starvation, suddenly advanced emaciation, or prolonged fasting, it was suspected that the transient adrenal hyporesponsiveness was the main cause of hypoglycemia.
Department of Pediatrics, Toho University Omori Medical Center, Tokyo, Japan. satomari@med.toho-u.ac.jp
Mari
M
Satoh
Keiko
K
Aso
Satoshi
S
Ikehara
Yumiko
Y
Komine
Tsutomu
T
Saji
D000309:Adrenal Insufficiency / Q000097:blood / Q000150:complications*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D002675:Child, Preschool; D005260:Female; D006111:Graves Disease / Q000150:complications*; D057238:Growth Charts; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006980:Hyperthyroidism / Q000150:complications*; D007003:Hypoglycemia / Q000209:etiology*; D012640:Seizures / Q000209:etiology
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone