A 26-year-old women comes to the offfice due to worsening fatigue and weight loss. She has a history of primary hypothyroidism and she takes levothyroxine. Physical examination is normal. Blood pressure is 115/75 mmHg supine and 92/61 mmHg on standing. Laboratory tesets show mild anemia with increase eosinophil count and serum glucose is 60 mg/dl. On physical examination shows an increased pigmentation around the nipple areola and anal and vaginal mucous membranes. Which of the following additional findings are most likely to be seen?

Question

A 26-year-old women comes to the offfice due to worsening fatigue and weight loss. She has a history of primary hypothyroidism and she takes levothyroxine. Physical examination is normal. Blood pressure is 115/75 mmHg supine and 92/61 mmHg on standing. Laboratory tesets show mild anemia with increase eosinophil count and serum glucose is 60 mg/dl. On physical examination shows an increased pigmentation around the nipple areola and anal and vaginal mucous membranes.  Which of the following additional findings are most likely to be seen?

Quizplus · Accepted Answer

Eductional Objective: Primary adrenal insufficiency (PAI) is characterized by weight loss, abdominal pain, fatigue, and hyperpigmentation.  Physiologic stress in patients with PAI can trigger acute adrenal crisis (eg, fever, shock, mental status changes).  Autoimmune adrenalitis is the most common cause of PAI and leads to bilateral adrenal atrophy.

A 26-Year-Old Women Comes to the Offfice Due to Worsening