ArticleCureus2024
Delayed Emergence of Isolated Secondary Adrenal Insufficiency: A Case Report.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
Secondary adrenal insufficiency (SAI) is a rare condition caused by adrenocorticotropic hormone (ACTH) deficiency, which disrupts ACTH secretion by the pituitary gland and can lead to chronic hyponatremia. However, idiopathic delayed onset of isolated adrenal insufficiency without triggering factors is an unusual finding and poses a challenging diagnosis. We present the case of an 80-year-old woman with hypothyroidism, hypertension, previous tobacco use, and squamous cell carcinoma of the ankle who presented with weakness and fatigue. Blood work showed hyponatremia (126 mmol/L), nonfasting blood glucose of 139 mg/dL, and elevated erythrocyte sedimentation rate (ESR, 83 mm/hr). Initial treatment included urea administration and water restriction. Initial imagining included a CT of the chest which revealed mediastinal lymphadenopathy, leading to suspicion of the syndrome of inappropriate antidiuretic hormone (SIADH) from malignancy. Despite increasing urea and adding NaHCO
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