We recommend investigation of the cause of hypokalemia in its own right, if it occurs with primary adrenal insufficiency.Īddison’s disease Hypokalemia Tubulopathy. The patient responded favorably to cortisol replacement, but never required fludrocortisone.Ĭoexistence of hypokalemia with Addison's disease is unusual. Investigations confirmed renal tubulopathy. Computed tomography scan of the adrenal glands showed features suggestive of unilateral adrenal tuberculosis. 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. 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. 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. We report a rare case of Addison's disease, coexisting with hypokalemia, requiring treatment. Primary adrenal insufficiency (Addison's disease) is a rare medical condition usually associated with hyperkalemia or normokalemia.
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