Painful Hypoadrenalism

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2012 Jun 16

PMID 22700071

Citations 5

Authors

Chisho Hoshino

Noriyuki Satoh

Masashi Narita

Akio Kikuchi

Minoru Inoue

Affiliations

Soon will be listed here.

Abstract

A 61-year-old man presented with diffuse myalgia and arthralgia. The physical examination showed diffuse musculoskeletal tenderness and joint stiffness without the presence of synovitis or arthritis. Nerve conduction study showed combined mild axonal degenerative and demyelinating change. Muscle biopsy analysis showed unspecific mild muscle atrophy with myopathic changes found on electromyography. A diagnosis of isolated adrenocorticotropic hormone deficiency was made on the basis of endocrinological evaluation. The widespread musculoskeletal pain resolved as a result of administration of physiological dose of hydrocortisone replacement. In a patient with unexplained rheumatic symptoms, adrenocortical insufficiency should be considered in the possible aetiology.

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