Challenges in Diagnosing Addison's Disease: A Case Report

Addison's disease, or primary adrenal insufficiency, is a rare condition characterized by a deficiency of adrenocortical hormones due to the damage of the adrenal glands. This case report presents a 36-year-old woman with a history of intestinal obstruction caused by adhesions and bands, who visited the emergency department with postprandial vomiting and epigastric discomfort. On physical examination, notable findings included bronzed skin, cutaneous hyperpigmentation, hyperpigmented scars and tongue, orange-colored teeth, decreased muscle strength in all four limbs, and mild gait imbalance. The patient also exhibited hyponatremia and hyperkalemia, which are common features of this disease. The diagnosis was confirmed by a computed tomography scan, which revealed adrenal gland calcifications. The patient was treated with hydrocortisone and fludrocortisone, resulting in significant clinical improvement. This case report underscores the importance of recognizing this condition and considering it in patients with nonspecific symptoms (fatigue, weight loss, and gastrointestinal disturbances), enabling effective therapy, including hormone replacement and continuous monitoring, which is crucial to optimize prognosis and prevent future complications.