A 47-year-old man presents with fatigue, anorexia, and lightheadedness. He underwent resection of a nonfunctioning pituitary macroadenoma 3 months ago. Physical examination shows low blood pressure but no hyperpigmentation. Laboratory studies show low morning cortisol, low ACTH, sodium 130 mEq/L, potassium 4.2 mEq/L, and normal anion gap. Which of the following is the most likely diagnosis?
- A)Congenital adrenal hyperplasia due to 21-hydroxylase deficiency
- B)Primary hyperaldosteronism
- C)Primary adrenal insufficiency
- D)Secondary adrenal insufficiencyGABARITO
- E)Tertiary hypercortisolism
Explicação
Secondary adrenal insufficiency results from decreased ACTH production by the pituitary. Cortisol is low but aldosterone secretion is largely preserved because it is primarily regulated by the renin angiotensin system, so hyperkalemia is usually absent. Ver explicação completa e trilha adaptativa →