Acute adrenocortical crisis and an abnormal electrocardiogram

Abstract

Acute adrenocortical crisis is often the first presentation of Addison's disease. The combination of pigmentation, peripheral circulatory failure and the electrolyte abnormality usually lead to suspicion and early treatment with corticosteroids is the key to the success in such cases. Failure of response to the standard treatment should highlight the possibility of a coexisting condition. We report a case where the patient did not respond to the treatment until such a condition was recognized.