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Addison's disease associated with hypokalemia: a case report
M Abdalla1, J A Dave1, I L Ross2
1Division of Endocrinology, Department of Medicine, Faculty of Health Sciences, Groote Schuur Hospital and University of Cape Town, Private Bag X3, J47-85 Old Main Building, Observatory, Cape Town, 7935, South Africa.
Journal of Medical Case Reports
|March 25, 2021
Summary
Primary adrenal insufficiency, typically linked to high potassium, can rarely present with low potassium. This case highlights the need to investigate hypokalemia in Addison's disease patients.
Area of Science:
- Endocrinology
- Nephrology
Background:
- Primary adrenal insufficiency (Addison's disease) is a rare endocrine disorder.
- It is typically associated with hyperkalemia or normokalemia.
Observation:
- A 42-year-old male presented with loss of consciousness and severe hypoglycemia.
- Diagnosed with Addison's disease, he unexpectedly exhibited hypokalemia (2.3 mmol/L).
- Adrenal CT suggested tuberculosis; investigations confirmed renal tubulopathy.
Findings:
- The patient was diagnosed with primary adrenal insufficiency and hypokalemia.
- He responded to cortisol replacement but did not require fludrocortisone.
- Adrenal tuberculosis and renal tubulopathy were identified as contributing factors.
Implications:
- Hypokalemia in Addison's disease is an unusual but significant clinical presentation.
- Investigating the cause of hypokalemia is crucial when it coexists with primary adrenal insufficiency.
- This case underscores the complex interplay between adrenal function and electrolyte balance.
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