title: Delayed diagnosis of Addison's disease: an approach to management.
abstract: Addison's disease accounts for the majority of cases of adrenal failure that are detected during hospital admissions. Unfortunately, prompt diagnosis of this condition is often delayed due to varied atypical manifestations and inadequate assessment at the time of presentation. We report a case of a 52-year-old woman who was detected to have hypotension during routine colonoscopy for evaluation of anaemia and progressive weight loss. During admission for evaluation of hypotension, she was also detected to have hyponatremia. Hyponatremia and hypotension failed to improve despite fluid resuscitation. Our endocrinological opinion was sought for and on further evaluation she was diagnosed with primary adrenal insufficiency. Glucocorticoid and mineralocorticoid replacement therapy were eventually instituted, which was followed by restoration of blood pressure and normalisation of serum sodium levels.
authors.affiliation: Department of Diabetes and Endocrinology, Tameside Hospital NHS Foundation Trust, Ashton under Lyne, Lancs, UK.
authors.forename: Janice V
authors.initials: JV
authors.lastname: Mascarenhas
authors.affiliation: Department of Diabetes and Endocrinology, Tameside Hospital NHS Foundation Trust, Ashton under Lyne, Lancs, UK.
authors.forename: Edward B
authors.initials: EB
authors.lastname: Jude
mesh_terms: D000224:Addison Disease / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D057210:Delayed Diagnosis; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D008901:Mineralocorticoids / Q000627:therapeutic use*; D012964:Sodium / Q000097:blood; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D005938:Glucocorticoids; D008901:Mineralocorticoids; D012964:Sodium