Which of the following is seen in Addison's disease: September 2007

Ans. D: Hypercalcemia Routine investigations in Addison disease may show: Hypercalcemia Hypoglycemia, low blood sugar (worse in children due to loss of glucocoicoid's glucogenic effects) Hyponatraemia due to loss of production of the hormone aldosterone Hyperkalemia due to loss of production of the hormone aldosterone Eosinophilia and lymphocytosis Metabolic acidosis (increased blood acidity), also due to loss of the hormone aldosterone because sodium reabsorption in the distal tubule is linked with acid/hydrogen ion (H+) secretion. Low levels of aldosterone stimulation of the renal distal tubule leads to sodium wasting in the urine and H+ retention in the serum. In suspected cases of Addison's disease, one needs to demonstrate that adrenal hormone levels are low even after appropriate stimulation (called the ACTH stimulation test) with synthetic pituitary ACTH hormone tetracosactide .