A Case Report on Addisons Disease: Clinical Presentation and Management

Abstract

Background: Addison’s disease, also known as primary adrenal insufficiency, is a rare endocrine disorder characterized by inadequate production of glucocorticoids and mineralocorticoids from the adrenal cortex. It can present with nonspecific symptoms and is often associated with autoimmune or infectious etiologies, such as tuberculosis.

Case Presentation: A 45-year-old male was admitted with complaints of nausea, vomiting, generalized weakness, hyperpigmentation of the buccal mucosa, and darkening of skin and nails. Laboratory investigations revealed hyponatremia, hypotension, and low serum cortisol levels. Imaging studies, including chest X-ray and CT scan, showed miliary tuberculosis and bilateral adrenal enlargement. The patient was diagnosed with Addison’s disease secondary to adrenal tuberculosis. Management included intravenous hydrocortisone, correction of electrolyte imbalance, antitubercular therapy, and supportive care. On discharge, oral hydrocortisone and fludrocortisone were prescribed, with counseling on medication adherence and lifestyle modification.

Conclusion: Addison’s disease remains a potentially life-threatening but treatable condition. Early recognition of characteristic features such as hyperpigmentation and persistent hyponatremia can facilitate timely diagnosis. Integrated management involving corticosteroid replacement, treatment of underlying causes, and patient education is essential to prevent adrenal crises and improve quality of life.