Dizziness and orthostatic hypotension in a college student

This case report describes a 19-year-old male college student without any major past medical history presenting with 3 days of dizziness, nausea, and vomiting. Initial vital signs showed tachycardia and orthostatic hypotension with hyponatremia identified during work up. He was initially thought to have viral gastroenteritis and treated with intravenous fluids, but experienced continued dizziness and orthostatic hypotension as well as weight loss and a bronzed skin tone over the following few days. Based on deteriorating clinical status, he required hospitalization for medical stabilization, evaluation, and treatment. He was ultimately diagnosed with primary adrenal insufficiency caused by autoimmune adrenal insufficiency. He was discharged in stable condition to outpatient care (endocrinology and college health) on maintenance steroids, with instructions for stress dosing when indicated.