Case Presentation: A 66-year-old Hispanic male with a history of primary hypertension and type 2 diabetes mellitus presents to hospital with 3 months of progressive fatigue, poor appetite, watery diarrhea, dizziness, and vomiting. Vital signs were notable for postural hypotension (BP 146/84 sitting, BP 118/72 standing). Physical examination was normal with no skin or mucous [...]

Case Presentation: Autoimmune Polyglandular Syndrome Type 2 is a rare syndrome, with a prevalence of 1.4 to 4.5 per 100,000, distinguished by an association between autoimmune thyroid disease, Addison’s disease, and/or Type 1 diabetes mellitus (Wang, 2016). It can be particularly challenging to diagnose, especially in a situation where the endocrinopathies develop simultaneously leading to [...]

Case Presentation: A 28 year old man presented to the ED with hypotension and tachycardia. Laboratory evaluation showed hyponatremia, hyperkalemia, hematocrit of 47.4, cortisol level<0.5, ACTH elevated at 886, TSH 11.91, Free T4 1.0 and negative anti TPO antibody. On admission, the patient had orthostatic hypotension and ashen grey skin tone. Cosyntropin stimulation test resulted [...]

Case Presentation: Addison’s disease, or primary adrenal insufficiency, is a rare disorder of glucocorticoid or mineralocorticoid deficiency caused by adrenal cortex dysfunction or destruction. Since the disease gradually progresses with nonspecific symptoms, patients are often misdiagnosed or diagnosed late. Consequently, patients receive delayed treatment and are at increased risk for Addisonian crisis, which continues to [...]

Case Presentation: A 23-year-old man without prior medical history was brought to the ED from his home for profound somnolence which had progressed over two days. EMTs at the scene noted that the patient was sluggishly responsive to painful stimuli. Initial vital signs were within normal limits, and a point-of-care glucose check was 28 mg/dL. [...]