Two Hurt More Than One: Severe Hyponatraemia and Rhabdomyolysis as Presenting Features of Addison's Disease.

Luca Foppiani, Christian Cascio, Paola Pesce, Giancarlo Antonucci
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Abstract

Addison's disease (AD) is characterized by non-specific symptoms and electrolyte disorders, namely hyponatraemia and hyperkalaemia; rhabdomyolysis is uncommon. AD may manifest at onset with a life-threatening adrenal crisis which is triggered by stressful events. We describe the case of a young man who was hospitalized for severe myalgia and fatigue. Severe hypotonic hyponatraemia, rhabdomyolysis and hypotension were found; hormonal assessment unexpectedly revealed primary adrenal insufficiency. Saline infusion and intravenous hydrocortisone significantly improved the patient's condition and normalized sodium and muscle enzyme levels; thereafter, he was switched to oral steroid therapy. The autoimmune origin of AD was ascertained by the positivity of adrenal cortex autoantibodies and 21b-hydroxylase autoantibodies. The association of hyponatraemia and rhabdomyolysis may be the initial finding of an as yet unknown AD, which requires proper investigation and treatment.

两害大于一害:严重低钠血症和横纹肌溶解是艾迪生病的表现特征。
艾迪生病(AD)的特点是非特异性症状和电解质紊乱,即低钠血症和高钾血症;横纹肌溶解不常见。阿尔茨海默病可能表现为由压力事件引发的危及生命的肾上腺危机。我们描述的情况下,一个年轻的男子谁是住院严重的肌痛和疲劳。重度低渗性低钠血症、横纹肌溶解、低血压;激素评估意外显示原发性肾上腺功能不全。生理盐水输注和静脉注射氢化可的松显著改善了患者的病情,使钠和肌酶水平正常化;此后,他改用口服类固醇治疗。通过肾上腺皮质自身抗体和21b-羟化酶自身抗体的阳性来确定AD的自身免疫性起源。低钠血症和横纹肌溶解的关联可能是一种尚不清楚的AD的初步发现,需要适当的调查和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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