A Rare Cause of Hypercalsemia: Acute Adrenal Failure

Yıl 2022, Cilt: 48 Sayı: 1, 99 - 102, 01.04.2022

Nida Uyar Burcu Dikeç Gökçe Mehmet Ali Eren Tevfik Sabuncu

https://doi.org/10.32708/uutfd.1037300

Öz

Adrenal insufficiency is a rare disease that can be seen 35-60 per million. Acute adrenal insufficiency or adrenal crisis is a life threatening situation that requires urgent intervention. Although acute adrenal insufficiency is accompanied by various electrolyte disturbances, hypercalcemia rarely occurs. In this article, we present a case admitted to the hospital with confusion that was diagnosed with adrenal insufficiency after the detection of hyperpigmentation, hypotension and hypoglycemia. and severe hypercalcemia associated with adrenal insufficiency.

Anahtar Kelimeler

adrenal crisis, hypercalcemia, hyperpigmentation

Hiperkalseminin Nadir Bir Nedeni: Akut Adrenal Yetmezlik

Öz

Adrenal yetmezlik milyonda 35-60 arasında görülebilen nadir bir hastalıktır. Akut adrenal yetmezlik veya adrenal kriz hayatı tehdit eden ve acil müdahale gerektiren bir durumdur. Akut adrenal yetmezlik sırasında çeşitli elektrolit bozukluklar görülebilirse de hiperkalsemi nadiren oluşmaktadır. Bu yazıda bilinç bulanıklığı nedeni ile başvurup hiperpigmentasyon, hipotansiyon ve hipoglisemi saptanarak adrenal yetmezlik ve adrenal yetmezlik ile ilişkili ciddi hiperkalsemi tanısı konulan bir vakayı sunduk.

Anahtar Kelimeler

adrenal kriz, hiperkalsemi, hiperpigmentasyon

Kaynakça

• 1- Charmandari E, Nicolaides NC, Chrousos GP. Adrenal insufficiency. The Lancet. 2014;383(9935):2152-67. doi: 10.1016/S0140-6736(13)61684-0.
• 2- Betterle, C., Presotto, F. & Furmaniak, J. Epidemiology, pathogenesis, and diagnosis of Addison’s disease in adults. J Endocrinol Invest 42, 1407–1433 (2019). https://doi.org/10.1007/s40618-019-01079-6
• 3- Ziegler R. Hypercalcemic crisis. J Am Soc Nephrol 12: S3-S9, 2001.
• 4- Jacobs TP, Bilezikian JP. Clinical review: Rare causes of hypercalcemia. J Clin Endocrinol Metab. 2005;90(11):6316–6322. doi: 10.1210/jc.2005-0675.
• 5- Nerup J. Addison’s disease-clinical studies: a report for 108 cases.Acta Endocrinol (Copenh) 76: 127-141, 1974. doi: 10.1530/acta.0.0760127.
• 6- Araujo CA, Araujo NA, Daher EF, et al. Resolution of hypercalcemia and acute kidney injury after treatment for pulmonary tuberculosis without the use of corticosteroids. Am J Trop Med Hyg. 2013;88(3):592–595. doi: 10.4269/ajtmh.11-0768. Epub 2013 Jan 21.
• 7- Williams PF, Thomson D, Anderton JL. Reversible renal failure due to isolated renal sarcoidosis. Nephron. 1984;37(4):246–249. doi: 10.1159/000183258.
• 8- Lee AS, Twigg SM. Opioid-induced secondary adrenal insufficiency presenting as hypercalcaemia. Endocrinol Diabetes Metab Case Rep. 2015;2015:150035. doi: 10.1530/EDM-15-0035.
• 9- Minisola S, Pepe J, Piemonte S, Cipriani C. The diagnosis and management of hypercalcaemia. BMJ. 2015;350:h2723. doi: 10.1136/bmj.h2723.
• 10- Kato A, Shinozaki S, Goga T, Hishida A. Isolated adrenocorticotropic hormone deficiency presenting with hypercalcemia in a patient on long-term hemodialysis. Am J Kidney Dis. 2003;42(2):E32–E36. doi: 10.1016/s0272-6386(03)00672-3.
• 11- Suzuki K, Nonaka K, Ichihara K, et al. Hypercalcemia in glucocorticoid withdrawal. Endocrinol Jpn 33: 203-209, 1986. doi: 10.1507/endocrj1954.33.203.
• 12- WALSER M, ROBINSON BH, DUCKETT JW Jr. The hypercalcemia of adrenal insufficiency. J Clin Invest. 1963 Apr;42(4):456-65. doi: 10.1172/JCI104734.
• 13- Terri G. Davidson, Pharm.D., BCOP, FASHP, FCCP, Conventional treatment of hypercalcemia of malignancy, American Journal of Health-System Pharmacy, Volume 58, Issue suppl_3, 1 November 2001, Pages S8–S15. doi: 10.1093/ajhp/58.suppl_3.S8.
• 14- Ahn SW, Kim TY, Lee S, Jeong JY, Shim H, Han YM, Choi KE, Shin SJ, Yoon HE. Adrenal insufficiency presenting as hypercalcemia and acute kidney injury. Int Med Case Rep J. 2016 Jul 29;9:223-6. doi: 10.2147/IMCRJ.S109840.
• 15- Yamada, S., Arase, H., Morishita, T. et al. Adrenal crisis presented as acute onset of hypercalcemia and hyponatremia triggered by acute pyelonephritis in a patient with partial hypopituitarism and pre-dialysis chronic kidney disease. CEN Case Rep 8, Nov 2019, 83–88. doi.org/10.1007/s13730-018-0371-9.