A 35-year-old woman presents with a 3-month history of chronic fatigue, progressive weight loss, and orthostatic dizziness. She reports intense salt cravings. Vital signs show BP 95/60 mmHg, HR 102 bpm, RR 18/min, temperature 37.2°C. Physical examination reveals diffuse hyperpigmentation of the buccal mucosa and oral mucous membranes. Laboratory studies show sodium 128 mEq/L, potassium 5.8 mEq/L, cortisol 2 mcg/dL, and ACTH 145 pg/mL. No fever or focal infection is noted. Which of the following is the most likely diagnosis?
- A)Addison diseaseGABARITO
- B)Pheochromocytoma
- C)Secondary adrenal insufficiency
- D)Cushing disease
- E)Conn syndrome
Explicação
This patient has primary adrenal insufficiency, most commonly autoimmune Addison disease. Low cortisol and low aldosterone produce hypotension, hyponatremia, and hyperkalemia, while elevated ACTH causes hyperpigmentation through increased POMC derived melanocy... Ver explicação completa e trilha adaptativa →