CBC and adrenal crisis

Q: Which CBC finding is highly suggestive of Adrenal crisis? (Select one)

A) Neutrophilia

B) Eosinophilia

C) Thrombocytopenia

D) Neutropenia

E) Polycythemia

Answer: B

Hyponatremia, hyperkalemia, metabolic acidosis, and hypoglycemia may be present along with anemia and lymphocytosis, but eosinophilia with said serum chemistry findings is highly suggestive of adrenal crisis.

#endo

#hematology

References:

1. Angelis M, Yu M, Takanishi D, Hasaniya NW, Brown MR. Eosinophilia as a marker of adrenal insufficiency in the surgical intensive care unit. J Am Coll Surg. 1996 Dec;183(6):589-96. PMID: 8957461.

2. Mouloudi E, Katsanoulas C, Vrochides D, Giasnetsova T, Papageorghiou C, Gritsi-Gerogianni N. Eosinophilia as a marker of adrenal insufficiency in critically ill patients with severe septic shock: 1-year prospective study. Crit Care. 2008;12(Suppl 5):P9. doi: 10.1186/cc7042. Epub 2008 Nov 18. PMCID: PMC3300601.

3. Beishuizen A, Vermes I, Hylkema BS, Haanen C. Relative eosinophilia and functional adrenal insufficiency in critically ill patients. Lancet. 1999 May 15;353(9165):1675-6. doi: 10.1016/s0140-6736(99)01346-x. PMID: 10335792