Addisonian crisis in a young man with atypical anorexia nervosa

The document reported on a 22-year-old man with a history of atypical anorexia nervosa who was admitted to intensive care for an Addisonian crisis, characterized by severe hyponatremia, hypotension, and somnolence. He was found to have primary adrenal insufficiency due to autoimmune adrenalitis. Treatment included immediate hydrocortisone and saline infusions, followed by chronic hormone replacement therapy with hydrocortisone and fludrocortisone. Despite initial improvement, he experienced a subsequent adrenal crisis 18 months later due to improper dose adjustment during illness. The case emphasized the need for considering Addison disease in psychiatric patients and the importance of education on crisis prevention and hormone therapy management. The document also discussed Addison disease diagnosis, etiology, treatment, and the necessity for improved educational strategies, as current methods led to insufficient crisis prevention.