Diarrhea as an atypical symptom of adrenal insufficiency: a clinical case report

Objective: To present a case of chronic diarrhea as an atypical manifestation of primary adrenal insufficiency in a young man. Main points: Diagnosis of primary adrenal insufficiency (AI) can take a long time due to diverse and uncharacteristic initial symptoms. Diarrhea is not a typical manifestation of AI and therefore can be mistakenly considered infectious or as a manifestation of irritable bowel syndrome even in patients with an established diagnosis of AI. We present a case of chronic diarrhea (more than 6 months) in a young man with primary AI, which developed due to unsatisfactory therapy of the underlying disease. After correction of hypocorticism diarrhea completely resolved. Conclusion: The diagnosis of AI can be delayed in primary patients, and AI can be underestimated in patients with an established diagnosis too. Chronic diarrhea is one of the symptoms of AI and clinicians should consider this in the differential diagnosis of patients corresponding to the clinical picture of this disease. Repetitive patient education on methods of controlling AI is very important, including adjusting the dosage of steroid medication in case of medical interventions, injuries and infections.