Paciente monorrena con diarrea de 2 semanas de evolución

ResumenMujer de 78 años con antecedentes personales de agenesia real derecha congénita. Acude por diarrea de 2 semanas de evolución aproximadamente y molestias en ambas piernas tipo calambre. Se realiza analítica donde se encuentra hiperpotasemia grave, hiponatremia y niveles de creatinina discretamente elevados, sin síntomas asociados a dicho hallazgo y con resto de pruebas complementarias normales. Se ingresa en la unidad de cuidados intensivos para tratamiento y tras normalizar los valores se traslada a medicina interna. Se realizan, entre otras pruebas, ACTH que aparece elevada y una RM donde encontramos un adenoma en suprarrenal izquierda. El diagnóstico final ha sido síndrome de Addison en tratamiento con mineralocorticoides y revisiones en consulta externa de medicina interna.

The case is presented of a 78 year old woman with a history of congenital right renal, who suffered from diarrhea of approximately 2 weeks duration and discomfort due to cramp in both legs. The laboratory results showed severe hyperkalemia, hyponatremia, and slightly elevated creatinine levels, with no symptoms associated with this finding and with the rest of the normal laboratory results. She was admitted to the intensive care unit for treatment, and when her results returned to normal she was transferred to internal medicine. Among the other tests performed, the ACTH was shown to be high, and a left adrenal adenoma was found in the MR scan. The final diagnosis was Addison's syndrome. She was treated with mineralocorticoids with follow-up by internal medicine as an outpatient.