Endocrinopathy

AMS is a rare presentation of these disorders. Patients with Addison disease present with nausea, vomiting, abdominal pain, weakness, malaise, hypotension, and mental status changes, including psychosis. Presumptive evidence is provided by finding hyperpigmentation, depressed sodium and blood sugar levels, an elevated potassium level, and a variably increased calcium level. Infants with congenital adrenal hyperplasia may present in an acute salt-losing, volume-depleted hypotensive crisis or with virilization, characterized by ambiguous genitalia and cortisol insufficiency also manifested as hypoglycemia. Thyrotoxic infants may present with ventricular dysrhythmia. Patients may also exhibit symptoms similar to those of adults, including goiter, irritability, exophthalmos, hyperthermia, high-output congestive heart failure, mania, delirium, psychosis, and, later, apathy and decreasing levels of consciousness. Patients with pheochromocytoma may present with hypertensive encephalopathy.

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