2nd May 2024

A 30-year-old woman is brought to the Emergency Department with severe fatigue, abdominal pain, and a history of recent weight loss.

A 30-year-old woman is brought to the Emergency Department with severe fatigue, abdominal pain, and a history of recent weight loss. She has a known diagnosis of Addison’s disease and has been on chronic maintenance dose of corticosteroids. Her blood pressure is 90/50 mmHg, pulse rate is 110 bpm, and she is hypoglycemic with a blood glucose level of 3.2 mmol/L.

Investigations:

Serum sodium: 125 mmol/L (135–145)

Serum potassium: 5.6 mmol/L (3.5–5.0)

Serum cortisol: Low

Which is the most appropriate initial treatment?