Hypertensive Encephalopathy with Overdosage of Deoxycorticosterone

Abstract

Deoxycorticosterone acetate (DOCA), a potent salt-retaining mineral corticoid, is widely used in the management of adrenal insufficiency, particularly in the adrenogenital syndrome. For convenience in long-term management, subcutaneous implantation of DOCA pellets is often employed. We report here a case of hypertensive encephalopathy following overdosage of DOCA pellets. This white male infant, the product of a normal pregnancy and delivery, was first diagnosed by his private physician as having the adrenogenital syndrome at 3 weeks of age when he presented with weight loss and shock. His initial serum potassium was 8.0 mEq per liter, his sodium was 135 mEq per liter, and his blood urea nitrogen was 69.2 mg per 100 ml.