Posaconazole-induced primary adrenal insufficiency concomitant with pseudoaldosteronism under normal blood pressure

Posaconazole causes PAI within 1 month of initial administration. Posaconazole-induced PAI may not present with hypotension or hyperkalemia. The hypothalamic-pituitary-adrenal axis improves, but the renin-angiotensin-aldosterone system may take longer to recover, as changes persist even 1 month after posaconazole discontinuation. Hypokalemia treatment should continue carefully until pseudohyperaldosteronism resolution.