Adrenal crisis due to addison ‘s disease presenting acute kidney failure: a rare presentation

Mickovski, Ivana and Eftimovska-Otovikj, Natasha and Poposka, Elizabeta and Popovska, Bojana (2024) Adrenal crisis due to addison ‘s disease presenting acute kidney failure: a rare presentation. In: 7th MSNDTAO Congress Macedonian Society of Nephrology, Dialysis and Artificial Organs with International participation and ISN supported CME course with ERA endorsement, 04-07 Apr 2024, Skopje, North Macedonia.

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Abstract

Introduction. AKI as a result of an adrenal crisis due
to Addison's disease has been rarely reported.
Case report. A 38-years-old man with past medical
history of congenital adrenal insufficiency and bilateral
orchiectomy presented to emergency confused, measured temperature 39C, abdominal pain two days prior
to admission, followed by severe nausea and vomiting. Detailed history revealed that he wasn’t taking
fludrocortisone for few months. He had low BP
(90/50mm Hg), HR 150/min, for which 2L of normal
saline was given. Laboratory showed creatinine 393
µmol/L, BUN 12 mmol/L, sodium of 129 mmol/l, CK
3710 U/L, CK-MB 314 U/L, CRP 111, Le 22.7. Other
laboratory results and urine were unremarkable.
Pancultures were negative. Chest X-ray confirmed
pneumonia. He underwent upper GI endoscopy due
to melena, showing ulcus ventriculi Forrest III. High
doses of hydrocortisone, antibiotics and aggressive
intravenous fluids led to improved kidney function
and eunatriemia within 10 days (creatinine 84 µmol/L,
BUN 7.6 mmol/L, CK 133 U/L, CK-MB 25 U/L, Na 139
mmol/L, CRP 16.1). No underlying cause of this rhabdomyolysis was identified, so it was considered secondary to Addisonian crisis induced hyponatremia.
Conclusion. We report hyponatremia-induced rhabdomyolysis in adrenal crisis resulted with AKI and
successfully resolved by conservative treatment.

Item Type:	Conference or Workshop Item (Poster)
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Ivana Mickovski
Date Deposited:	15 Apr 2024 07:17
Last Modified:	15 Apr 2024 07:17
URI:	https://eprints.ugd.edu.mk/id/eprint/34009

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