SECONDARY ADRENAL INSUFFICIENCY MIMICKING ABDOMINAL CAUSE OF RECURRENT ABDOMINAL PAIN IN A PREPUBERTAL GIRL

Ana Milenović, Ljiljana Šaranac, Vasiliki Toli, Dragana Ilić, Zlatko Đurić

DOI Number
http://doi.org/10.22190/FUMB191223016M
First page
101
Last page
106

Abstract


Recurrent abdominal pain (RAP) in children is defined as at least three episodes of pain that occur over at least three months and affect the child's ability to perform normal activities. The prevalence of recurrent abdominal pain in a population of schoolchildren varies from 10% to even 45%. Pituitary disorders are rarely considered as causative factor in children with abdominal pain, especially in absence of midline facial defects and in case of emergency, when growth monitoring is neglected or not performed carefully. Herein we report an unusual case of RAP caused by secondary adrenal insufficiency. An 8-year-old girl was hospitalized repeatedly because of RAP. Biological parameters including white blood cell count, hemoglobin value, C-reactive protein, glucose, electrolytes were within the normal range. Low cortisol combined with low ACTH values was the clue for diagnosis. The magnetic resonance imaging (MRI) of the pituitary region revealed anterior pituitary hypoplasia and pituitary stalk interruption. To the best of our knowledge, this is the first report of child with RAP caused by pituitary disorder. Possible inherited, autoimmune and post-traumatic causative factors are discussed.


Keywords

recurent abdominal pain, pituitary hypoplasia, secondary adrenal insufficiency, growth hormone deficiency, hypopituitarism, pituitary stalk lesion

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References


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DOI: https://doi.org/10.22190/FUMB191223016M

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