A case of adrenal insufficiency presented with acute abdomen and hypoglycaemia

Addison’s disease usually presents with non-specific symptoms like fatigue, nausea, vomiting, hyper-pigmentation and generalized weakness. These symptoms are most often ignored or misinterpreted with other more common diseases (Depression, Somatoform disorder). This is the major reason that this disease is under-diagnosed. Therefore, to establish a diagnosis, high index of suspicion is needed. We are reporting a case of 30 years old female who presented with recurrent episode of acute abdomen and severe hypoglycaemia. Careful history (long lasting fatigue, weakness, lack of energy, nausea, anorexia, weight loss, hyper-pigmentation etc.) and careful interpretation of laboratory value (Hyponatremia, Hyperkalemia, hypoglycaemia, anaemia, hypercalcemia, neutropenia, eosinophilia, normal lipase etc.) will dictate the diagnosis of adrenal insufficiency. After that only confirmatory ACTH stimulation test (Synacthen) to be done.