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Case Reports
. 2023 Jul 7;15(7):e41528.
doi: 10.7759/cureus.41528. eCollection 2023 Jul.

When Stress Is Not the Only Culprit: A Case of Secondary Adrenal Insufficiency in a Young Patient With Graves' Disease

Saleha Ozair  1 , Hiram Maldonado-Rivera  2 , Kimberly Medina-Morales  1 , Echols Marti  3 , Eugenio Angueira-Serrano  4 , George Michel  1
Affiliations
Case Reports

When Stress Is Not the Only Culprit: A Case of Secondary Adrenal Insufficiency in a Young Patient With Graves' Disease

Saleha Ozair et al. Cureus. .

Abstract

This case report underscores the significance of maintaining a broad list of differential diagnoses, including adrenal insufficiency, when evaluating patients who present with recurring episodes of hypotension and generalized fatigue. It further underscores that T3 thyrotoxicosis can manifest as the initial and sole presenting feature of Graves' disease. Finally, it emphasizes the critical importance of employing a multidisciplinary approach to discharge high-risk patients from the hospital to minimize the risk of acute decompensation.

Keywords: addisonian crisis; graves' disease; hypotension; secondary adrenal insufficiency; t3-thyrotoxicosis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Radioactive iodine uptake (RAIU) scan showing homogeneously increased thyroid uptake of 42%, suggestive of Graves' disease
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