An endocrinological emergency masquerading as an overdose.
Primary adrenocortical insufficiency (Addison's disease) is a potentially life-threatening endocrinological disorder caused by destruction of the adrenal cortex with consequent reduction in glucocorticoid and mineralocorticoid function. Although this is a rare condition, misdiagnosis can result in fatal consequences. Previous case reports have described the neuropsychiatric manifestations of Addison's disease which can result in misdiagnosis. Here the authors describe how a psychiatric history combined with atypical biochemical results can point towards a mistaken diagnosis of poisoning and hence disguise an Addisonian crisis.
Acute General Medicine Department, University of Oxford, Oxford, Oxfordshire, UK. n.sinha35@gmail.com
Nihal
N
Sinha
Faisal
F
Rahman
Mirae
M
Shin
Peter
P
Burbridge
D000138:Acidosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D000224:Addison Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D003937:Diagnosis, Differential; D062787:Drug Overdose / Q000175:diagnosis*; D004562:Electrocardiography; D004630:Emergencies; D005260:Female; D006801:Humans