Adrenal insufficiency often presents with nonspecific symptoms, physical findings, and laboratory results, leading to diagnostic challenges. However, reports have indicated that specific symptoms such as hypergeusia (hypersensitivity to taste) and hyperosmia (hypersensitivity to smell) can also occur. We report the case of a 60-year-old male with loss of appetite, fatigue, and polyarthralgia, where a detailed medical history revealed the cause of anorexia to be hypergeusia and hyperosmia. These specific symptoms led to the diagnosis of adrenal insufficiency. Treatment with oral steroids for secondary adrenal insufficiency resulted in the improvement of his diverse symptoms. This case illustrates that in patients presenting with chronic nonspecific symptoms, inquiring about heightened taste and smell sensitivity can prompt suspicion of adrenal insufficiency. Moreover, this case serves as a reminder that careful medical history taking in patients with nonspecific symptoms can uncover specific findings that may be diagnostic clues.
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http://dx.doi.org/10.7759/cureus.59038 | DOI Listing |
Introduction: Consensus regarding the diagnostic cutoff values for cortisol responses to low-dose Cosyntropin testing (LDT) and its specific advantages over standard (high) dose test (HDT) in assessing the pituitary-adrenal axis in children is lacking.
Methods: In a retrospective study, patients who underwent sequential LDT and HDT were classified into two groups depending on the reason for testing: prolonged systemic glucocorticoid exposure (Group 1) or suspected hypothalamic-pituitary dysfunction (Group 2). Sensitivity and specificity analysis of varying cortisol levels during LDT in diagnosing ACTH deficiency (ACTHD) were calculated via the receiver operating characteristic curve (ROC) analysis against the reference diagnostic test HDT.
J Am Anim Hosp Assoc
January 2025
From the Washington State University College of Veterinary Medicine, Pullman, Washington.
A 7 wk old female spayed domestic shorthair was evaluated for 3 days of lethargy and anorexia 1 wk after ovariohysterectomy. On presentation, she was weak, dehydrated, and hypotensive. Blood work showed azotemia, hyponatremia, hyperkalemia, hyperphosphatemia, and hyperproteinemia.
View Article and Find Full Text PDFCureus
December 2024
Department of Diabetes, Metabolism and Endocrinology, Japan Labor Health and Safety Organization, Tokyo Rosai Hospital, Tokyo, JPN.
Severe hypoglycemia (SH) is a significant risk, particularly in the elderly, and adrenal insufficiency (AI) may be a contributing factor. This study examines six cases of late dumping syndrome (LDS)-induced reactive hypoglycemia (RH), with AI as a potential trigger. Three of the six patients were diagnosed with AI, and one experienced a hypoglycemic coma.
View Article and Find Full Text PDFBMC Pediatr
January 2025
Geriatric Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Background: This case report describes a unique presentation of sphingosine-1-phosphate lyase insufficiency syndrome (SPLIS) caused by a rare SGPL1 variant, highlighting the diagnostic and management challenges associated with this condition.
Case Presentation: A 2-year-old Iranian female presented with steroid-resistant nephrotic syndrome (NS), primary adrenal insufficiency (AI), growth delay, seizures, and hyperpigmentation. Laboratory evaluation revealed hypoalbuminemia, significant proteinuria, hyperkalemia, and elevated adrenocorticotropic hormone (ACTH) levels.
Clin Teach
February 2025
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Introduction: Pediatric endocrinology education is a fundamental part of all pediatric endocrinology training. Hence, understanding the current methods used for training learners on skills required and understanding methods or topics that may be underexplored could help improve the quality of training.
Objective: This study aims to explore training and assessment strategies used in pediatric endocrinology training across medical education programs through a scoping review.
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