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. Which of the following additional changes is most likely in this patient?

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Quizplus · Accepted Answer

Eductional Objective: Autoimmune disease is a common cause of primary adrenal insufficiency. Reduction of aldosterone production result in renal sodium wasting with consequent hypovolemia, orthostasis, and potassium retention (hyperkalemia).  Low cortisol stimulates increased antidiuretic hormone secretion, which leads to water retention and hyponatremia.

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