A 16-year-old girl presents to the pediatrician complaining of severe headaches that began 3 weeks ago. Upon further questioning, she also admits that she has been bumping into walls and corners of tables recently and her vision “just hasn’t been the same.” She denies photophobia, nausea, or vomiting associated with the headaches, and there is no family history of migraines. Her past medical history is only significant for a bilateral adrenalectomy 4 years ago for Cushing disease. Her current medications include hydrocortisone acetate and a multivitamin. On exam, the physician notes hyperpigmentation of the skin extending up the midline from the pubis to the umbilicus, as well as on the gingivae and areolae. The serum ACTH level is found to be markedly elevated (3420 pg/mL), and the serum cortisol level is dimished, but the rest of her labs are within normal limits. Based on this information, which of the following is the most likely diagnosis? A. Addison disease B. Adrenoleukodystrophy C. Hemochromatosis D. Nelson syndrome E. Prolactinoma
Posted on: Tue, 09 Jul 2013 11:12:28 +0000
Trending Topics
Recently Viewed Topics
© 2015