Circulatory collapse requiring mechanical circulatory support in a child with autoimmune adrenal insufficiency: a case report

Background We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical ex...

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Vydáno v:	BMC pediatrics Ročník 24; číslo 1; s. 656 - 5
Hlavní autoři:	Hejazi, Yahia, Tegtmeyer, Ken, Chlebowski, Meghan, Gist, Katja M.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	London BioMed Central 14.10.2024 BioMed Central Ltd Springer Nature B.V BMC
Témata:	Addison Disease - complications Addison Disease - diagnosis Adrenal insufficiency Adrenal Insufficiency - complications Adrenal Insufficiency - diagnosis Antibodies Asthma in children Autoimmune adrenal insufficiency Blood oxygenation, Extracorporeal Cardiac arrest Cardiac arrhythmia Cardiac catheterization Cardiopulmonary resuscitation Care and treatment Case Report Case reports Child Circulatory shock Complications and side effects Congenital diseases CPR Development and progression Disease Emergency medical care Extracorporeal membrane oxygenation Extracorporeal membrane oxygenation (ECMO) Extracorporeal Membrane Oxygenation - methods Heart Humans Hydrocortisone - blood Hydrocortisone - therapeutic use Hypoglycemia Hyponatremia Intensive care Internal Medicine Intubation Ischemia Laboratories Male Medical diagnosis Medicine Medicine & Public Health Myocarditis Patient outcomes Patients Pediatrics Pneumonia Prevention Risk factors Shock Shock, Cardiogenic - etiology Shock, Cardiogenic - therapy SIDS Skin Steroids Sudden infant death syndrome Ultrasonic imaging United States Autoimmune adrenal insufficiency Circulatory shock Extracorporeal membrane oxygenation (ECMO)
ISSN:	1471-2431, 1471-2431
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Abstract	Background We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical exam can often provide valuable diagnostic information for timely therapy. Case presentation A 7-year-old boy with a history of mild intermittent asthma, presented with severe cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO). Bronzing of his entire body was noted on physical exam. Stress dose hydrocortisone was given for suspected adrenal insufficiency. After weaning from ECMO and extensive rehabilitation, the patient recovered and was discharged home. Conclusion Primary adrenal insufficiency (PAI) should be considered in the context of physical exam and laboratory findings, even in the presence of circulatory shock.
AbstractList	BackgroundWe report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical exam can often provide valuable diagnostic information for timely therapy.Case presentationA 7-year-old boy with a history of mild intermittent asthma, presented with severe cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO). Bronzing of his entire body was noted on physical exam. Stress dose hydrocortisone was given for suspected adrenal insufficiency. After weaning from ECMO and extensive rehabilitation, the patient recovered and was discharged home.ConclusionPrimary adrenal insufficiency (PAI) should be considered in the context of physical exam and laboratory findings, even in the presence of circulatory shock. Background We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical exam can often provide valuable diagnostic information for timely therapy. Case presentation A 7-year-old boy with a history of mild intermittent asthma, presented with severe cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO). Bronzing of his entire body was noted on physical exam. Stress dose hydrocortisone was given for suspected adrenal insufficiency. After weaning from ECMO and extensive rehabilitation, the patient recovered and was discharged home. Conclusion Primary adrenal insufficiency (PAI) should be considered in the context of physical exam and laboratory findings, even in the presence of circulatory shock. Keywords: Circulatory shock, Autoimmune adrenal insufficiency, Extracorporeal membrane oxygenation (ECMO) Abstract Background We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical exam can often provide valuable diagnostic information for timely therapy. Case presentation A 7-year-old boy with a history of mild intermittent asthma, presented with severe cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO). Bronzing of his entire body was noted on physical exam. Stress dose hydrocortisone was given for suspected adrenal insufficiency. After weaning from ECMO and extensive rehabilitation, the patient recovered and was discharged home. Conclusion Primary adrenal insufficiency (PAI) should be considered in the context of physical exam and laboratory findings, even in the presence of circulatory shock. We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical exam can often provide valuable diagnostic information for timely therapy. A 7-year-old boy with a history of mild intermittent asthma, presented with severe cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO). Bronzing of his entire body was noted on physical exam. Stress dose hydrocortisone was given for suspected adrenal insufficiency. After weaning from ECMO and extensive rehabilitation, the patient recovered and was discharged home. Primary adrenal insufficiency (PAI) should be considered in the context of physical exam and laboratory findings, even in the presence of circulatory shock. We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical exam can often provide valuable diagnostic information for timely therapy. Primary adrenal insufficiency (PAI) should be considered in the context of physical exam and laboratory findings, even in the presence of circulatory shock. Background We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical exam can often provide valuable diagnostic information for timely therapy. Case presentation A 7-year-old boy with a history of mild intermittent asthma, presented with severe cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO). Bronzing of his entire body was noted on physical exam. Stress dose hydrocortisone was given for suspected adrenal insufficiency. After weaning from ECMO and extensive rehabilitation, the patient recovered and was discharged home. Conclusion Primary adrenal insufficiency (PAI) should be considered in the context of physical exam and laboratory findings, even in the presence of circulatory shock. We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical exam can often provide valuable diagnostic information for timely therapy.BACKGROUNDWe report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the current era of readily available imaging, laboratory and other diagnostic investigations, medical history and careful physical exam can often provide valuable diagnostic information for timely therapy.A 7-year-old boy with a history of mild intermittent asthma, presented with severe cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO). Bronzing of his entire body was noted on physical exam. Stress dose hydrocortisone was given for suspected adrenal insufficiency. After weaning from ECMO and extensive rehabilitation, the patient recovered and was discharged home.CASE PRESENTATIONA 7-year-old boy with a history of mild intermittent asthma, presented with severe cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO). Bronzing of his entire body was noted on physical exam. Stress dose hydrocortisone was given for suspected adrenal insufficiency. After weaning from ECMO and extensive rehabilitation, the patient recovered and was discharged home.Primary adrenal insufficiency (PAI) should be considered in the context of physical exam and laboratory findings, even in the presence of circulatory shock.CONCLUSIONPrimary adrenal insufficiency (PAI) should be considered in the context of physical exam and laboratory findings, even in the presence of circulatory shock.
ArticleNumber	656
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Author	Chlebowski, Meghan Gist, Katja M. Hejazi, Yahia Tegtmeyer, Ken
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Snippet	Background We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory... We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory support. In the... Background We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory... BackgroundWe report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical circulatory... Abstract Background We report a rare case of new onset autoimmune adrenal insufficiency in childhood, presenting with severe shock requiring mechanical...
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SubjectTerms	Addison Disease - complications Addison Disease - diagnosis Adrenal insufficiency Adrenal Insufficiency - complications Adrenal Insufficiency - diagnosis Antibodies Asthma in children Autoimmune adrenal insufficiency Blood oxygenation, Extracorporeal Cardiac arrest Cardiac arrhythmia Cardiac catheterization Cardiopulmonary resuscitation Care and treatment Case Report Case reports Child Circulatory shock Complications and side effects Congenital diseases CPR Development and progression Disease Emergency medical care Extracorporeal membrane oxygenation Extracorporeal membrane oxygenation (ECMO) Extracorporeal Membrane Oxygenation - methods Heart Humans Hydrocortisone - blood Hydrocortisone - therapeutic use Hypoglycemia Hyponatremia Intensive care Internal Medicine Intubation Ischemia Laboratories Male Medical diagnosis Medicine Medicine & Public Health Myocarditis Patient outcomes Patients Pediatrics Pneumonia Prevention Risk factors Shock Shock, Cardiogenic - etiology Shock, Cardiogenic - therapy SIDS Skin Steroids Sudden infant death syndrome Ultrasonic imaging
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Title	Circulatory collapse requiring mechanical circulatory support in a child with autoimmune adrenal insufficiency: a case report
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