A 34-year-old woman comes to the clinic because of progressive fatigue, salt craving, nausea, and 7-kg unintentional weight loss over 4 months. She has autoimmune thyroid disease. Physical examination shows diffuse hyperpigmentation of the buccal mucosa and palmar creases. Laboratory studies show sodium 128 mEq/L, potassium 5.8 mEq/L, bicarbonate 18 mEq/L, and glucose 64 mg/dL. Which of the following is the most likely diagnosis?
- A)Primary hyperaldosteronism
- B)Pheochromocytoma
- C)Primary adrenal insufficiencyGABARITO
- D)Cushing syndrome
- E)Secondary adrenal insufficiency
Explicação
Primary adrenal insufficiency causes deficient cortisol and aldosterone production. Low cortisol causes weakness and hypoglycemia, low aldosterone causes hyponatremia and hyperkalemia, and elevated ACTH from POMC generates MSH causing hyperpigmentation. Ver explicação completa e trilha adaptativa →