Estudio de caso de la enfermedad de Addison
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Químicas
Resumen
El presente estudio de caso, trata de un paciente de 85 años de edad, ingresado en el Hospital Universitario de Gran Canaria, el mismo que presentaba la triada de la enfermedad de Addison (hiperpigmentación, hiponatremia e hipotensión) fiebre, malestar generalizado, dolores osteomusculares, urocultivo positivo para Escherichia Coli. El paciente había recibido tratamiento antibiótico pero mantenía el cuadro epidemiológico, se sospecha una fiebre Q recibiendo doxiciclina y corticoides, presentando mejoría. Al terminar la medicación de los corticoides reinicia el cuadro de malestar general, debilidad, fiebre, etc.exacerbándose ya la tríada clínica para la enfermedad de Addison, Se inicia entonces la búsqueda del perfil hormonal confirmándose la falla suprarrenal, y realizando pruebas específicas como los anticuerpos anticapsulas suprarrenales. Después del diagnóstico se inicia el tratamiento en base a corticoides, el cual llega a un feliz término. El presente estudio de caso revela la importancia del diagnóstico precoz frente a la sintomatología del paciente y la necesidad del médico y del labortario clínico de estar en capacidad de poder diagnosticar frente a la emergencia.
The present case study deals with an 85-year-old patient admitted to the University Hospital of Gran Canaria, who presented the triad of Addison's disease (hyperpigmentation, hyponatremia and hypotension) fever, generalized malaise, musculoskeletal pain, Positive urine culture for Escherichia coli. The patient had received antibiotic treatment but maintained the epidemiological picture, a Q fever is suspected receiving doxycycline and corticosteroids, presenting improvement. At the end of the corticosteroid medication, the general malaise, weakness, fever, etc. already exacerbated, and the clinical triad for Addison's disease is resumed. The search for the hormonal profile begins, confirming adrenal failure, and performing specific tests such as Adrenal anticapsulin antibodies. After the diagnosis, corticoid treatment is started, which reaches a happy ending. The present case study reveals the importance of early diagnosis in relation to the symptomatology of the patient and the need of the physician and clinical worker to be able to diagnose in the face of the emergency.
The present case study deals with an 85-year-old patient admitted to the University Hospital of Gran Canaria, who presented the triad of Addison's disease (hyperpigmentation, hyponatremia and hypotension) fever, generalized malaise, musculoskeletal pain, Positive urine culture for Escherichia coli. The patient had received antibiotic treatment but maintained the epidemiological picture, a Q fever is suspected receiving doxycycline and corticosteroids, presenting improvement. At the end of the corticosteroid medication, the general malaise, weakness, fever, etc. already exacerbated, and the clinical triad for Addison's disease is resumed. The search for the hormonal profile begins, confirming adrenal failure, and performing specific tests such as Adrenal anticapsulin antibodies. After the diagnosis, corticoid treatment is started, which reaches a happy ending. The present case study reveals the importance of early diagnosis in relation to the symptomatology of the patient and the need of the physician and clinical worker to be able to diagnose in the face of the emergency.
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HORMONA LIBERADORA DE CORTICOTROPINA (CRH), CORTICOTROPINA (ACTH), CORTISOL, HIPOTENSIÓN, HIPONATREMIA, GLÁNDULA SUPRARRENAL