Adrenal Crisis Mimicking COVID-19 Encephalopathy in a Teenager with Craniopharyngioma
There is an increasing number of reported cases with neurological manifestations of COVID-19 in children. Symptoms include headache, general malaise, ageusia, seizure and alterations in consciousness. The differential diagnosis includes several potentially lethal conditions including encephalopathy,...
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| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/8/1238 |
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| author | Tzu-Chien Chien Mu-Ming Chien Tsai-Ling Liu Hsi Chang Min-Lan Tsai Sung-Hui Tseng Wan-Ling Ho Yi-Yu Su Hsiu-Chen Lin Jen-Her Lu Chia-Yau Chang Kevin Li-Chun Hsieh Tai-Tong Wong James S. Miser Yen-Lin Liu |
| author_facet | Tzu-Chien Chien Mu-Ming Chien Tsai-Ling Liu Hsi Chang Min-Lan Tsai Sung-Hui Tseng Wan-Ling Ho Yi-Yu Su Hsiu-Chen Lin Jen-Her Lu Chia-Yau Chang Kevin Li-Chun Hsieh Tai-Tong Wong James S. Miser Yen-Lin Liu |
| author_sort | Tzu-Chien Chien |
| collection | DOAJ |
| description | There is an increasing number of reported cases with neurological manifestations of COVID-19 in children. Symptoms include headache, general malaise, ageusia, seizure and alterations in consciousness. The differential diagnosis includes several potentially lethal conditions including encephalopathy, encephalitis, intracranial hemorrhage, thrombosis and adrenal crisis. We report the case of a 17-year-old boy with a positive antigen test of COVID-19 who presented with fever for one day, altered mental status and seizure, subsequently diagnosed with adrenal insufficiency. He had a history of panhypopituitarism secondary to a suprasellar craniopharyngioma treated with surgical resection; he was treated with regular hormone replacement therapy. After prompt administration of intravenous hydrocortisone, his mental status returned to normal within four hours. He recovered without neurologic complications. Adrenal insufficiency can present with neurological manifestations mimicking COVID-19 encephalopathy. Prompt recognition and treatment of adrenal insufficiency, especially in patients with brain tumors, Addison’s disease or those recently treated with corticosteroids, can rapidly improve the clinical condition and prevent long-term consequences. |
| first_indexed | 2024-03-09T13:39:30Z |
| format | Article |
| id | doaj.art-92374469d19c483abb01419a2e872cd3 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T13:39:30Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-92374469d19c483abb01419a2e872cd32023-11-30T21:08:59ZengMDPI AGChildren2227-90672022-08-0198123810.3390/children9081238Adrenal Crisis Mimicking COVID-19 Encephalopathy in a Teenager with CraniopharyngiomaTzu-Chien Chien0Mu-Ming Chien1Tsai-Ling Liu2Hsi Chang3Min-Lan Tsai4Sung-Hui Tseng5Wan-Ling Ho6Yi-Yu Su7Hsiu-Chen Lin8Jen-Her Lu9Chia-Yau Chang10Kevin Li-Chun Hsieh11Tai-Tong Wong12James S. Miser13Yen-Lin Liu14Department of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanPediatric Brain Tumor Program, Taipei Cancer Center, Taipei Medical University, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanPediatric Brain Tumor Program, Taipei Cancer Center, Taipei Medical University, Taipei 110, TaiwanPediatric Brain Tumor Program, Taipei Cancer Center, Taipei Medical University, Taipei 110, TaiwanPediatric Brain Tumor Program, Taipei Cancer Center, Taipei Medical University, Taipei 110, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei 110, TaiwanThere is an increasing number of reported cases with neurological manifestations of COVID-19 in children. Symptoms include headache, general malaise, ageusia, seizure and alterations in consciousness. The differential diagnosis includes several potentially lethal conditions including encephalopathy, encephalitis, intracranial hemorrhage, thrombosis and adrenal crisis. We report the case of a 17-year-old boy with a positive antigen test of COVID-19 who presented with fever for one day, altered mental status and seizure, subsequently diagnosed with adrenal insufficiency. He had a history of panhypopituitarism secondary to a suprasellar craniopharyngioma treated with surgical resection; he was treated with regular hormone replacement therapy. After prompt administration of intravenous hydrocortisone, his mental status returned to normal within four hours. He recovered without neurologic complications. Adrenal insufficiency can present with neurological manifestations mimicking COVID-19 encephalopathy. Prompt recognition and treatment of adrenal insufficiency, especially in patients with brain tumors, Addison’s disease or those recently treated with corticosteroids, can rapidly improve the clinical condition and prevent long-term consequences.https://www.mdpi.com/2227-9067/9/8/1238COVID-19SARS-CoV-2craniopharyngiomapanhypopituitarismadrenal insufficiencyseizure |
| spellingShingle | Tzu-Chien Chien Mu-Ming Chien Tsai-Ling Liu Hsi Chang Min-Lan Tsai Sung-Hui Tseng Wan-Ling Ho Yi-Yu Su Hsiu-Chen Lin Jen-Her Lu Chia-Yau Chang Kevin Li-Chun Hsieh Tai-Tong Wong James S. Miser Yen-Lin Liu Adrenal Crisis Mimicking COVID-19 Encephalopathy in a Teenager with Craniopharyngioma Children COVID-19 SARS-CoV-2 craniopharyngioma panhypopituitarism adrenal insufficiency seizure |
| title | Adrenal Crisis Mimicking COVID-19 Encephalopathy in a Teenager with Craniopharyngioma |
| title_full | Adrenal Crisis Mimicking COVID-19 Encephalopathy in a Teenager with Craniopharyngioma |
| title_fullStr | Adrenal Crisis Mimicking COVID-19 Encephalopathy in a Teenager with Craniopharyngioma |
| title_full_unstemmed | Adrenal Crisis Mimicking COVID-19 Encephalopathy in a Teenager with Craniopharyngioma |
| title_short | Adrenal Crisis Mimicking COVID-19 Encephalopathy in a Teenager with Craniopharyngioma |
| title_sort | adrenal crisis mimicking covid 19 encephalopathy in a teenager with craniopharyngioma |
| topic | COVID-19 SARS-CoV-2 craniopharyngioma panhypopituitarism adrenal insufficiency seizure |
| url | https://www.mdpi.com/2227-9067/9/8/1238 |
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