title: First presentation of Addison's disease as hyperkalaemia in acute kidney injury.
abstract: Addison's disease is a rare endocrine disorder that frequently presents with non-specific symptoms, but may deteriorate rapidly into life-threatening Addisonian crisis if left untreated. Diagnosis can be difficult in patients without a suggestive medical history. We describe a case of a 37-year-old man who was admitted with acute kidney injury and hyperkalaemia, resistant to treatment with insulin/dextrose and calcium gluconate. On clinical examination, he was found to be hyperpigmented; a subsequent random serum cortisol of 49 nmol/L affirmed the preliminary diagnosis of Addison's disease. The patient's hyperkalaemia improved on treatment with hydrocortisone, and a follow-up morning adrenocorticotropic hormone of 1051 ng/L confirmed the diagnosis.
authors.affiliation: Department of Acute Medicine, Hillingdon Hospital, Uxbridge, UK.
authors.forename: Sara
authors.initials: S
authors.lastname: Maki
authors.affiliation: Department of Acute Medicine, Hillingdon Hospital, Uxbridge, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Kramarz
authors.affiliation: Imperial College London, London, UK.
authors.forename: Paula Maria
authors.initials: PM
authors.lastname: Heister
authors.affiliation: Department of Acute Medicine, Hillingdon Hospital, Uxbridge, UK Imperial College London, London, UK.
authors.forename: Kamran
authors.initials: K
authors.lastname: Pasha
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy / Q000209:etiology*; D000224:Addison Disease / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000627:therapeutic use; D006947:Hyperkalemia / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D016896:Treatment Outcome
chemical_list: D006854:Hydrocortisone