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Acute adrenal insufficiency: A new presentation of Castleman's disease
Author(s) -
CRUMP J. A.,
BEARD M. E. J.,
ANGUS H. B.,
FRASER R.,
HART D. N. J.,
NICHOLLS M. G.
Publication year - 1995
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1995.tb00903.x
Subject(s) - medicine , anasarca , adrenal insufficiency , constitutional symptoms , disease , presentation (obstetrics) , antibody , pathology , immunology , surgery
. We report the case of a 35‐year‐old patient who presented with acute adrenal insufficiency, then developed fever, hypoalbuminuria, anasarca, thrombocytopaenia and anaemia. Lymphadenopathy appeared later with microscopic features typical of Castleman's disease. Clinical remission followed treatment with intravenous immunoglobulin. Circulating interleukin‐6 levels were elevated initially but were normal after immunoglobulin therapy. We surmise that high circulating levels of interleukin‐6 (and ACTH) may have induced haemorrhagic necrosis of the adrenal glands and accounted for the constitutional symptoms.