Prompt differentiation of Addison's disease from anorexia nervosa during weight loss and vomiting

Citation
R. Adams et al., Prompt differentiation of Addison's disease from anorexia nervosa during weight loss and vomiting, SOUTH MED J, 91(2), 1998, pp. 208-211
Citations number
9
Categorie Soggetti
General & Internal Medicine
Journal title
SOUTHERN MEDICAL JOURNAL
ISSN journal
00384348 → ACNP
Volume
91
Issue
2
Year of publication
1998
Pages
208 - 211
Database
ISI
SICI code
0038-4348(199802)91:2<208:PDOADF>2.0.ZU;2-G
Abstract
An 18-years-old white woman had nausea, vomiting, weight loss, and a diagno sis of anorexia nervosa. Copper-colored skin was noted on physical examinat ion, and serum chemistry values were normal. Subsequent fever, disorientati on, and confusion led to the discovery of Addison's disease, which responde d well to corticosteroid replacement therapy, Addisonian and anorexic patie nts exhibit clinical similarities, including nausea, vomiting, weight loss, abdominal pain, cold intolerance, hypothermia, and orthostasis, Other comm onalities include prolongation of electrocardiographic PR and QT intervals and generalized slowing on electroencephalogram. Important differences incl ude a brown color to the skin in Addison's disease instead of a yellowish c olor in anorexia. Addisonian patients also display hypocortisolism, hypogly cemia, and hyperkalemia, in contrast to the hypercortisolism, hyperglycemia , and hypokalemia seen in anorexia.