title: Hypoglycaemic coma due to adrenal failure in a chronic haemodialysis patient.
abstract: A 62-year-old man, receiving chronic haemodialysis and suffering from alcoholic liver cirrhosis and chronic pancreatitis, presented with hypoglycaemic coma. Plasma cortisol was undetectable (< 5.5 nmol/L) with suppressed adrenocorticotropic hormone (ACTH), which established a diagnosis of adrenal failure due to ACTH deficiency. Twenty-five milligrams of oral hydrocortisone eradicated hypoglycaemia. Presentation of adrenal failure in this patient was atypical because he was hypertensive, serum electrolytes including sodium were normal and anaemia was unremarkable, which were all due to end-stage renal disease and its treatment with haemodialysis. As far as we are aware, this is the first case report of hypoglycaemic coma due to adrenal failure in a chronic haemodialysis patient.
authors.affiliation: Diabetes Center.
authors.forename: Masami
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Diabetes Center.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Suganuma
authors.affiliation: Diabetes Center.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Funase
authors.affiliation: Department of Nephrology.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Minami
authors.affiliation: Department of Nephrology.
authors.forename: Katsuko
authors.initials: K
authors.lastname: Shirotori
authors.affiliation: Department of Nephrology.
authors.forename: Tomomasa
authors.initials: T
authors.lastname: Oguchi
authors.affiliation: Emergency and Critical Care Center , Aizawa Hospital , Matsumoto , Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kamijo
authors.affiliation: Emergency and Critical Care Center , Aizawa Hospital , Matsumoto , Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Diabetes Center.
authors.forename: Toru
authors.initials: T
authors.lastname: Aizawa
keywords: adrenal failure; haemodialysis; hypoglycaemia