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29 August 2022: Articles

An Unusual Presentation of Adrenocortical Carcinoma (ACC): Panic Attacks and Psychosis

Unusual clinical course, Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Yassine Kilani A* , Aye Myat Mon E , Trisha Laxamana B , Syeda Ashna Fatima Kamal B , Rahul Zain B , Haris Sohail E , Mubarak H. Yusuf E , Julia Vargas-Jerez E , Tasneem Zahra E

DOI: 10.12659/AJCR.937298

Am J Case Rep 2022; 23:e937298

Table 1. Summary of the laboratory findings. Note that the increased renin level and the appropriately suppressed aldosterone level in the setting of excessive cortisol is suggestive of angiotensin-converting enzyme inhibitors (ACEI), used by our patient for hypertension treatment.

Results (reference range)
Complete blood countHemoglobin 15.0 (12.0–16.0 g/dL)Platelets 333 (150–450×10/mcL)White blood cells 11.71(4.80–10.80×10/mcL)Neutrophils 80.7 (44.0–70.0%)Lymphocytes 12.0 (20.0–45.0%)Monocytes 6.1 (2.0–10.0%)Eosinophils 0.0 (1.0–4.0%)Basophils 0.3 (0.2–1.8%)
Basic metabolic panelSodium 147 mmol/L (136–145 mmol/L)Potassium 2.7 mmol/L (3.5–5.1 mmol/L)Chloride 99 mmol/L (98–107 mmol/L)Calcium 10.4 mg/dL (8.4–10.5 mg/dL)Bicarbonates 33 mmol/L (22–29 mmol/L)Glucose 260 mg/dL (74–109 mg/dL)BUN 17.0 mg/dL (6.0–23.0 mg/dL)Creatinine 0.59 mg/dL (0.50–0.90 mg/dL)
Urine electrolytes (random)Sodium 47 mmol/LPotassium 25 mmol/L (20 mmol/L)Chloride 35 mmol/L
Diabetes mellitus testingHbA1c 8.1 (4.0–5.6%)
Thyroid function testsTSH 1.41 (0.27–4.20 uIU/mL)
Adrenal function testsSerum aldosterone
Neuroendocrine tumor screenChromogranin A level 85.8 (0.0–101.8 ng/mL)

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923