A 6-year-old boy with fulminant meningococcemia suddenly develops shock, disseminated intravascular coagulation, and bilateral flank discoloration. Autopsy would show massive hemorrhage into both adrenal glands. This presentation results in acute deficiency of which hormones?

• A Catecholamines only
• B Aldosterone only
• C Glucocorticoids and mineralocorticoids ✓
• D Epinephrine and norepinephrine

Explanation

Waterhouse-Friderichsen syndrome is bilateral adrenal hemorrhagic necrosis, classically in meningococcal septicemia in children. Destruction of the entire cortex causes acute primary adrenocortical insufficiency with loss of both glucocorticoids and mineralocorticoids, producing shock, hypotension, and electrolyte disturbance. The medulla and its catecholamines are not the clinically dominant loss, and aldosterone alone cannot explain the full picture.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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