Which condition is most likely in a patient presenting with weight loss and fatigue along with elevated liver enzymes, elevated potassium, and decreased sodium?
Addison disease (primary adrenal insufficiency) results in insufficient production of cortisol and aldosterone. The hallmark laboratory findings include:
Hyponatremia (low sodium)
Hyperkalemia (high potassium)
Elevated liver enzymes (due to nonspecific hepatic involvement)
Fatigue, weight loss, and hypotension are common clinical features.
Conn syndrome (B) causes hyperaldosteronism, leading to hypokalemia (not hyperkalemia).
Acute pancreatitis (C) would typically show elevated amylase/lipase.
Hepatocellular carcinoma (D) may present with elevated liver enzymes but not the electrolyte pattern described.
Reference Extracts:
Nieman LK. "Diagnosis and Treatment of Primary Adrenal Insufficiency." J Clin Endocrinol Metab. 2011;96(7):1957-1966.
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
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