Addison's disease A 12-year-old girl presented with vague abdominal discomfort for 6 months. She had noticed occasional diarrhea but had not passed...

Addison's disease

A 12-year-old girl presented with vague abdominal discomfort for 6 months. She had noticed occasional diarrhea but had not passed any blood. She admitted to weight loss (6kg) and anorexia. On examination, she was obviously pigmented, although she thought this was sun induced; however, her buccal mucosa and gums were also brown. There were no other physical signs. She had a low cortisol level and her response to the adrenocorticotrophic hormone in a Synacthen test was poor. A diagnosis of adrenal cortical failure was made. X-ray of her abdomen showed no calcified areas in either adrenal gland, and her serum contained antibodies to adrenal cortex, consistent with a diagnosis of Addison's disease due to autoimmune adrenalitis.