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Addison’s Disease Presenting with Cerebral Edema

Published online by Cambridge University Press:  18 September 2015

Caroline Geenen ,
Ingrid Tein  and
Robert M. Ehrlich
Caroline Geenen*
Affiliation:
Divisions of Neurology (C.G., IT.) and Endocrinology (R.M.E.), The Hospital for Sick Children, Toronto
Ingrid Tein*
Affiliation:
Divisions of Neurology (C.G., IT.) and Endocrinology (R.M.E.), The Hospital for Sick Children, Toronto
Robert M. Ehrlich*
Affiliation:
Divisions of Neurology (C.G., IT.) and Endocrinology (R.M.E.), The Hospital for Sick Children, Toronto
*
Division of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
Division of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
Division of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
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Abstract:

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Background: Increased intracranial pressure with encephalopathy has rarely been reported in Addison’s disease. Method: Case Study. Results: A 16-year-old female who presented with cerebral edema of unknown etiology was eventually diagnosed as having Addison’s disease. She had early morning headaches, fatiguability, diarrhea and deterioration in school performance. She was hyponatremic with a serum sodium of 128 mmol/L and hyperkalemic with a serum potassium of 5.9 mmol/L. She had a low serum osmolality (264 mosm), high urine osmolality (533 mosm) and high urine sodium (87 mosm). She had a postural drop in blood pressure and diffuse hyperpigmentation. An ACTH stimulation test revealed a low baseline Cortisol and no response to ACTH. Plasma renin activity was increased. Serum ACTH was elevated. She responded well to intravenous fluids and solu-cortef and was discharged on hydrocortisone and florinef. She remains well 18 months after the acute episode with no neurologic complaints or findings. Conclusion: Addison’s Disease should be considered in the differential diagnosis of symptomatic cerebral edema and idiopathic intracranial hypertension.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 23 , Issue 2 , February 1996 , pp. 141 - 144
Copyright
Copyright © Canadian Neurological Sciences Federation 1996

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