Acute Gastroenteritis Induced Adrenal Crisis in a patient with Congenital Adrenal Hyperplasia: A Case Report

JNMA J Nepal Med Assoc. 2023 Jan 1;61(257):84-86. doi: 10.31729/jnma.7926.

Abstract

Congenital Adrenal Hyperplasia is a group of autosomal recessive diseases due to deficiencies of enzymes involved in steroidogenesis. If not diagnosed and treated adequately, Congenital Adrenal Hyperplasia can lead to an acute adrenal crisis with hemodynamic collapse. Acute stressors and steroid insufficiency precipitate an adrenal crisis. The major clinical features are hypotension and volume depletion. Nonspecific symptoms such as fatigue, lack of energy, anorexia, nausea, vomiting, and abdominal pain are common. We report a case of a 3-year male previously diagnosed with congenital adrenal hyperplasia in adrenal crisis secondary to medicine noncompliance and gastroenteritis. The diagnosis was based on the clinical history and biochemical investigations. After initial resuscitation was managed; lifelong oral prednisolone and fludrocortisone were prescribed.

Keywords: adrenal insufficiency; gastroenteritis; glucocorticoids.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adrenal Hyperplasia, Congenital* / complications
  • Adrenal Hyperplasia, Congenital* / diagnosis
  • Adrenal Insufficiency* / complications
  • Adrenal Insufficiency* / etiology
  • Gastroenteritis* / complications
  • Gastroenteritis* / diagnosis
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Prednisolone / therapeutic use

Substances

  • Glucocorticoids
  • Prednisolone