Acute Oncology Guidelines
- Routine screening for Addison’s disease is not indicated. The same initial screen as for hypophysitis should be performed. The cortisol results should be discussed with an endocrinologist.
- Treatment with hydrocortisone should be commenced as above, if there is a high index of suspicion.
Addisons
Addison’s disease is rare in this context. Symptoms are again vague and there is overlap with some of the symptoms of hypophysitis. The key symptoms are:
- fatigue
- low mood
- weight loss
- postural hypotension
- increased pigmentation – especially of surgical scars, skin creases.
The classical biochemical picture of hyponatraemia and hyperkalaemia is not always seen in Addison’s disease, but their presence should mandate further investigation.