A 3-year-old girl with Graves’ disease with hypoglycemia following transient adrenal hyporesponsiveness

• Published in: Journal of Pediatric Endocrinology and Metabolism Vol. 24; no. 11-12; pp. 1047 - 1050
• Main Authors: Satoh, Mari, Aso, Keiko, Ikehara, Satoshi, Komine, Yumiko, Saji, Tsutomu
• Format: Journal Article
• Language: English
• Published: Germany Walter de Gruyter 01.12.2011
• Subjects: adrenal hyporesponsiveness; Adrenal Insufficiency - blood; Adrenal Insufficiency - complications; Adrenocorticotropic Hormone - blood; Child, Preschool; Female; Graves Disease - complications; Growth Charts; Humans; Hydrocortisone - blood; Hyperthyroidism - complications; hyperthyroidsim; hypoglycemia; Hypoglycemia - etiology; Seizures - etiology
• ISSN: 0334-018X; 2191-0251
• DOI: 10.1515/JPEM.2011.307

A 3-year-old girl with Graves’ disease developed a generalized convulsion as a result of hypoglycemia (25 mg/dL). At the time of the hypoglycemic seizure, her plasma adrenocorticotropin (ACTH) level (1460 pg/mL) was extremely high, but her serum cortisol level (28.4 μg/dL) was relatively low given the severe stress. The cortisol-releasing hormone (CRH) provocation test done after thyroid function had improved revealed normal ACTH and cortisol responses. Since there was no other cause of hypoglycemia, such as hyperinsulin­emia, long-term starvation, suddenly advanced emaciation, or prolonged fasting, it was suspected that the transient adrenal hyporesponsiveness was the main cause of hypoglycemia.