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Biomedical Science: Pathophysiology of Disease - Case Study Example

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"Biomedical Science: Pathophysiology of Disease" paper identifies what is the most probable diagnosis in the patient based on the patient’s clinical presentation and laboratory results, and explains the hyponatremia, decreased bicarbonate and decreased serum osmolality…
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Biomedical Science: Pathophysiology of Disease
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Download file to see previous pages Initial investigations revealed hyponatremia, potassium on the upper-side normal limit, and low free cortisol levels (5 micrograms/dL, Normal: 10-34 micro g/dL), all of which point to the diagnosis of adrenocortical insufficiency. A high index of suspicion is essential for diagnosis.

Adrenocorticodeficiency may be primary or secondary (Williams and Dluhy, 2008). Primary adrenocortical deficiency refers to Addison disease and occurs due to the destruction of the adrenal glands (Williams and Dluhy, 2008). Secondary adrenocorticodeficiency occurs due to decreased production of adrenocorticotropin by the pituitary gland (Williams and Dluhy, 2008). This hormone is essential for the stimulation of the adrenal glands to produce cortisol. The deficiency of this hormone causes decreased production of cortisol. Over a period of time, decreased stimulation of the adrenal glands results in shrinkage of the adrenal glands (Williams and Dluhy, 2008). In this patient, the most probable diagnosis is primary adrenocorticodeficiency or Addison disease and he is admitted to the Addisonian crisis.

Addison's disease was first described by Thomas Addison and hence the name (Griffing and Odeke, 2009). The disease is rare. The incidence in Great Britain is about 30 per 1 million population (Griffing and Odeke, 2009). In Denmark, it has been reported as 60 per one million population and in the United States, 40-60 cases per one million population (Griffing and Odeke, 2009). The morbidity and mortality associated with the disease are mainly due to delay or failure in arriving at the diagnosis and failure to adequately replace appropriate corticosteroids. Untreated and inappropriately treated Addisonian crisis eventually results in death. The deterioration may be triggered by adrenal hemorrhage, acute health condition, or inadequate steroid replacement. The most common age of presentation is 30-50 years, although, in conditions like congenital adrenal hyperplasia, polyglandular syndromes, and long-chain fatty acid metabolism disorders, the disease may occur earlier (Griffing and Odeke, 2009). ...Download file to see next pagesRead More
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