Delayed Diagnosis of Graves' Thyrotoxicoisis Presenting as Recurrent Adrenal Crisis in Primary Adrenal Insufficiency. | Department of Endocrinology, Diabetes & Metabolism
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Delayed Diagnosis of Graves’ Thyrotoxicoisis Presenting as Recurrent Adrenal Crisis in Primary Adrenal Insufficiency.

  1. Associate Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College , Vellore, Tamil Nadu, India .
  2. Senior Registrar, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College , Vellore, Tamil Nadu, India .
  3. Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College , Vellore, Tamil Nadu, India .

Journal of clinical and diagnostic research : JCDR Vol. 10 · Issue 4 · pp. OD20-2

PMID 27190873 DOI 10.7860/jcdr/2016/16395.7678

Cite This Article

Dukhabandhu Naik, K Felix Jebasingh, Nihal Thomas. Delayed Diagnosis of Graves’ Thyrotoxicoisis Presenting as Recurrent Adrenal Crisis in Primary Adrenal Insufficiency. Journal of clinical and diagnostic research : JCDR. 2016;10(4):OD20-2. doi:10.7860/jcdr/2016/16395.7678

Abstract

Adrenal crisis is a potential life threatening complication. The common causes of adrenal crisis are infections, surgical stress and abrupt cessation of steroid medications. Endocrine causes like Graves' disease with thyrotoxicosis is one of the less common causes of an adrenal crisis. We report a 42-year-old female who presented with recurrent episodes of adrenal crisis due to delayed diagnosis of thyrotoxicosis. She was initially treated with Carbimazole followed by Radio-iodine ablation and currently she is euthyroid. Her adrenal insufficiency was initially treated with hydrocortisone during the time of adrenal crisis followed by Prednisolone 5 mg once daily in the morning along with fludrocortisone 50 mcg once daily. This case highlights the need for high index of suspicion and less common causes like thyrotoxicosis should be ruled out in patients with adrenal crisis.

Keywords

  • Graves’ disease
  • Hydrocortisone
  • Prednisolone
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