A 38-year-old woman presents with a 3-month history of progressive fatigue, weight loss, and orthostatic dizziness. She reports intense salt cravings. On examination, BP is 92/58 mmHg, HR 102/min, and diffuse hyperpigmentation is noted on buccal mucosa and skin creases. Laboratory studies reveal sodium 128 mEq/L, potassium 5.8 mEq/L, and morning cortisol 3 μg/dL. Adrenal CT shows normal adrenal size with no masses. Which of the following is the most likely diagnosis?
- A)Hyperaldosteronism
- B)Pheochromocytoma
- C)Primary adrenal insufficiencyGABARITO
- D)Secondary adrenal insufficiency
- E)SIADH
Explicação
Primary adrenal insufficiency, or Addison disease, causes loss of cortisol and aldosterone production. High ACTH levels lead to hyperpigmentation because ACTH is derived from POMC, which also gives rise to MSH. Hyponatremia, hyperkalemia, orthostatic symptoms,... Ver explicação completa e trilha adaptativa →