Addison's disease associated with hypokalemia: a case report

Primary adrenal insufficiency (Addison's disease) is a rare medical condition usually associated with hyperkalemia or normokalemia. We report a rare case of Addison's disease, coexisting with hypokalemia, requiring treatment. In this case, a 42-year-old man was admitted to the intensive ca...

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Bibliographic Details
Published in:Journal of medical case reports 2021-03, Vol.15 (1), p.131-131, Article 131
Main Authors: Abdalla, M, Dave, J A, Ross, I L
Format: Article
Language:English
Subjects:
Acidosis
ACTH
Addison Disease - complications
Addison Disease - diagnosis
Addison Disease - drug therapy
Addison’s disease
Adrenal Glands
Adult
Autoimmune diseases
Blood
Blood pressure
Case Report
Case reports
Consciousness
Creatinine
Diagnostic imaging
Electrolytes
Endocrine disorders
Fludrocortisone
Fludrocortisone - therapeutic use
Glucose
Health aspects
Humans
Hydrocortisone - therapeutic use
Hypokalemia
Hypokalemia - complications
Laboratories
Male
Medical examination
Metabolism
Patients
Potassium
Sodium
Thyroid gland
Tuberculosis
Tubulopathy
Urine
Ventilators
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Summary:Primary adrenal insufficiency (Addison's disease) is a rare medical condition usually associated with hyperkalemia or normokalemia. We report a rare case of Addison's disease, coexisting with hypokalemia, requiring treatment. In this case, a 42-year-old man was admitted to the intensive care unit with a history of loss of consciousness and severe hypoglycemia. His blood tests showed metabolic acidosis, low concentrations of cortisol 6 nmol/L (normal 68-327 nmol/L), and high plasma adrenocorticotropic hormone 253 pmol/L (normal 1.6-13.9 pmol/L), and he was diagnosed with primary adrenal insufficiency. Surprisingly, his serum potassium was low, 2.3 mmol/L (normal 3.5-5.1 mmol/L), requiring replacement over the course of his admission. Computed tomography scan of the adrenal glands showed features suggestive of unilateral adrenal tuberculosis. Investigations confirmed renal tubulopathy. The patient responded favorably to cortisol replacement, but never required fludrocortisone. Coexistence of hypokalemia with Addison's disease is unusual. We recommend investigation of the cause of hypokalemia in its own right, if it occurs with primary adrenal insufficiency.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-021-02724-6