Box 1.
Symptoms

  • Abdominal pain

  • Nausea

  • Myalgia

  • Weight loss

  • Fatigue

  • Dizziness

On examination

  • Hypotension/shock

  • Fever

  • Skin hyperpigmentation (primary adrenal insufficiency only)

Biochemistry

  • Hyponatraemia

  • Hyperkalaemia

  • ↑Urea

  • Metabolic acidosis

  • ↑TSH

  • Hypercalcaemia (uncommon)

  • Hypoglycaemia (more common in children)

  • Lymphocytosis

  • Eosinophilia