Adrenal Crisis Mimicking COVID-19 Encephalopathy in a Teenager with Craniopharyngioma

Autor: Tzu-Chien Chien, Mu-Ming Chien, Tsai-Ling Liu, Hsi Chang, Min-Lan Tsai, Sung-Hui Tseng, Wan-Ling Ho, Yi-Yu Su, Hsiu-Chen Lin, Jen-Her Lu, Chia-Yau Chang, Kevin Li-Chun Hsieh, Tai-Tong Wong, James S. Miser, Yen-Lin Liu
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Children, Vol 9, Iss 8, p 1238 (2022)
Druh dokumentu: article
ISSN: 2227-9067
DOI: 10.3390/children9081238
Popis: There is an increasing number of reported cases with neurological manifestations of COVID-19 in children. Symptoms include headache, general malaise, ageusia, seizure and alterations in consciousness. The differential diagnosis includes several potentially lethal conditions including encephalopathy, encephalitis, intracranial hemorrhage, thrombosis and adrenal crisis. We report the case of a 17-year-old boy with a positive antigen test of COVID-19 who presented with fever for one day, altered mental status and seizure, subsequently diagnosed with adrenal insufficiency. He had a history of panhypopituitarism secondary to a suprasellar craniopharyngioma treated with surgical resection; he was treated with regular hormone replacement therapy. After prompt administration of intravenous hydrocortisone, his mental status returned to normal within four hours. He recovered without neurologic complications. Adrenal insufficiency can present with neurological manifestations mimicking COVID-19 encephalopathy. Prompt recognition and treatment of adrenal insufficiency, especially in patients with brain tumors, Addison’s disease or those recently treated with corticosteroids, can rapidly improve the clinical condition and prevent long-term consequences.
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