Reversible cardiomyopathy in a child with Addison's disease

Abstract

An 11-year-old boy in acute adrenal crisis was subsequently diagnosed with Addison's disease and presumably had an unrecognized preceding chronic adrenal insufficiency. His adrenal insufficiency and hypovolemic shock were promptly diagnosed and treated in the emergency room. However, 24 h later, signs of congestive heart failure developed and an echocardiogram revealed cardiomyopathy. He responded to i.v. dopamine and his cardiomyopathy resolved over some days. Acute adrenal insufficiency and actual ventricular dysfunction had not been described in humans until last year; this is the second reported case of cardiomyopathy in a patient with acute adrenal insufficiency.

Ampulla (Takotsubo) Cardiomyopathy Caused by Secondary Adrenal Insufficiency in ACTH Isolated Deficiency

“…Addison's disease, an autoimmune destruction of the adrenal glands, is the most common cause of primary adrenal insufficiency. The majority of cases of adrenal insufficiency accompanied by cardiomyopathy are reported to be caused by primary adrenal insufficiency in the pediatric age group [8][9][10]. Only three cases of reversible cardiomyopathy associated with adrenal insufficiency have been reported in adult patients [5][6][7].…”

Takotsubo Cardiomyopathy during Acute Adrenal Crisis due to Isolated Adrenocorticotropin Deficiency

“…This state is usually termed adrenal crisis. However, cardiomyopathy induced by adrenal crisis is very uncommon (11)(12)(13)(14)(15)(16)(17)(18).…”

Acute reversible cardiomyopathy with cardiogenic shock in a patient with Addisonian crisis: A case report

“…A similar case in an adult has only been described by Afzal [2]. Although three more cases have been observed among children [3][4][5], the condition appears to be a rare complication of Addisonian crisis. However, due to its potentially life-threatening character, cardiologists and intensive care physicians should be aware of the disorder.…”