A Rare Case of Addison’s Disease Diagnosed During Early Pregnancy

Abstract

Brendan McNeal and Aundrea Loftley

Addison’s disease is a rare autoimmune condition in which the adrenal gland is attacked by the body’s own immune cells, leading to a decreased production of cortisol and aldosterone. This condition can present insidiously with overlap of symptoms related to the physiologic effects of pregnancy. We report the case of a first trimester pregnant woman with a history of type 1 diabetes mellitus and Hashimoto’s thyroiditis who presented with intractable vomiting and hyponatre- mia. The patient had presented with similar, less severe symptoms in years prior but was not diagnosed with Addison’s due to confounding illnesses and other factors. Many of the patient’s presenting symptoms were thought to be pregnancy related. She was eventually diagnosed with Addison’s disease and oral hydrocortisone and fludrocortisone were initiated for treatment. Addison’s disease is rare and is easily masked by symptoms associated with pregnancy Timely recognition and diagnosis are necessary to prevent adverse maternal-fetal outcomes.

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