Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Mar 25;15(1):131.
doi: 10.1186/s13256-021-02724-6.

Addison's disease associated with hypokalemia: a case report

M Abdalla  1 , J A Dave  1 , I L Ross  2
Affiliations
Case Reports

Addison's disease associated with hypokalemia: a case report

M Abdalla et al. J Med Case Rep. .

Abstract

Background: 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.

Case presentation: 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.

Conclusions: 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.

Keywords: Addison’s disease; Hypokalemia; Tubulopathy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Hahner S, Loeffler M, Bleicken B, Drechsler C, Milovanovic D, Fassnacht M, et al. Epidemiology of adrenal crisis in chronic adrenal insufficiency: the need for new prevention strategies. Eur J Endocrinol. 2010;162(3):597–602. doi: 10.1530/EJE-09-0884. - DOI - PubMed
    1. Barnett AH, Espiner EA, Donald RA. Patients presenting with Addison’s disease need not be pigmented. Postgrad Med J. 1982;58(685):690–692. doi: 10.1136/pgmj.58.685.690. - DOI - PMC - PubMed
    1. Zelissen PMJ, Bast EJEG, Croughs RJM. Associated autoimmunity in Addison’s disease. J Autoimmun. 1995;8(1):121–130. doi: 10.1006/jaut.1995.0009. - DOI - PubMed
    1. Bancos I, Hahner S, Tomlinson J, Arlt W. Diagnosis and management of adrenal insufficiency. Lancet Diabetes Endocrinol. 2015;3(3):216–226. doi: 10.1016/S2213-8587(14)70142-1. - DOI - PubMed
    1. Bornstein SR, Allolio B, Arlt W, Barthel A, Don-Wauchope A, Hammer GD, et al. Diagnosis and treatment of primary adrenal insufficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(2):364–389. doi: 10.1210/jc.2015-1710. - DOI - PMC - PubMed

Publication types