title: Acute mental status change as the presenting feature of adrenal insufficiency in a patient with autoimmune polyglandular syndrome type II and stroke.
abstract: Primary adrenal insufficiency (AI) in children usually presents with non-specific symptoms such as fatigue, nausea, vomiting, and anorexia. Here, we report an unusual case of a 15 year old girl who presented with acute mental status change and was ultimately diagnosed with AI due to autoimmune polyglandular syndrome type II (APS2). Central nervous system imaging revealed a cerebral infarction. To our knowledge, the constellation of APS2, stroke and acute mental status change has not been previously reported. We review the literature with regard to the presentation of AI as well as the association between vasculitis and APS2.
authors.forename: Sara
authors.initials: S
authors.lastname: Watson
authors.forename: Shekar
authors.initials: S
authors.lastname: Raj
authors.forename: Erica
authors.initials: E
authors.lastname: Eugster
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchez
mesh_terms: D000293:Adolescent; D000309:Adrenal Insufficiency / Q000150:complications / Q000523:psychology*; D000374:Aggression / Q000523:psychology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003221:Confusion / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D016884:Polyendocrinopathies, Autoimmune / Q000150:complications / Q000523:psychology*; D011241:Prednisone / Q000627:therapeutic use; D020521:Stroke / Q000150:complications / Q000523:psychology*; D013974:Thyroxine / Q000627:therapeutic use; D014549:Urinary Incontinence / Q000209:etiology
chemical_list: D000893:Anti-Inflammatory Agents; D013974:Thyroxine; D011241:Prednisone