Congenital Adrenal Cortical Insufficiency with Virilism

نویسنده

Daniel C. Darrow

چکیده

This paper presents the case of a boy developing symptoms of adrenal insufficiency soon after birth, followed by unmistakable evidences of the changes in the development associated with androgens. Other reports bring out the fact that the picture of increased androgenic activity with or without adrenocortical insufficiency is associated with hyperplasia and persistence of the fetal (androgenic) cells of the adrenal cortex. Presumably, this case belongs in this category. The patient is the younger brother of a normal sister. The mother, aged 29 years, is healthy but has suffered from recurring headaches that may be due to migraine. The maternal great grandmother had diabetes. The father is well except for a history of kidney stones. The birth weight was 3100 grams. The mother thought the baby was not quite normal at birth since he nursed poorly and seemed to have a good deal of mucus in his throat. Although the mother seemed to have enough milk, he was given artificial feeding because of feeble sucking. He took 30 grams of a milk mixture every four hours in the hospital without vomiting. On the eighth day he was taken home, weighing only 2650 grams. Three days later he returned to the hospital because he had vomited after practically all feedings and was in a state of collapse from dehydration (weight 2500 grams). The diagnosis of pyloric stenosis was entertained because of the story, but the vomitus was bile tinged and other signs of this disease were absent. Despite repeated clyses of physiological saline the boy remained extremely sick and dehydrated; he vomited a good deal and had one or two loose stools. When four weeks old he was transferred to the New Haven Hospital because of these difficulties.

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