Fatal Rotavirus Infection in a 4-Year-Old with Unsuspected Autoimmune Adrenal Insufficiency
| Autor: | Alison Krywanczyk, Elizabeth A. Bundock |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Abdominal pain
medicine.medical_specialty Case of the Month business.industry Adrenal crisis Autopsy medicine.disease medicine.disease_cause Gastroenterology Pathology and Forensic Medicine Primary Adrenal Insufficiency 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine Rotavirus Immunology medicine Adrenal insufficiency Vomiting Congenital adrenal hyperplasia 030216 legal & forensic medicine medicine.symptom business |
| Popis: | The diagnosis of adrenal insufficiency is often delayed, as the presenting symptoms of fatigue, abdominal pain, and anorexia are vague and nonspecific. However, timely diagnosis and treatment with replacement steroids are needed to prevent fatal adrenal crisis. While the most common cause of primary adrenal insufficiency in childhood is congenital adrenal hyperplasia, a significant minority (13-23%) is caused by autoimmune destruction of the gland. We present a case of a 4-year-old, previously healthy child who had a one-day history of nausea and vomiting, and was found unresponsive by her caretaker. Despite emergency rescue and transport to the hospital, she was pronounced dead. At autopsy, the adrenal glands were atrophied. Histologic examination revealed lymphocytic infiltration of the adrenal glands consistent with autoimmune adrenal insufficiency. Fecal viral antigen testing was positive for rotavirus. The cause of death was determined to be adrenal crisis in the setting of rotavirus gastroenteritis due to adrenal insufficiency (Addison disease). |
| Databáze: | OpenAIRE |
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