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.  

Investigations

  • 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. 

Editorial Information

Last reviewed: 01/05/2017

Author(s): Strachan M.

Version: 1.0

Reviewer name(s): Stewart J.