Adrenal involvement due to sarcoidosis presenting with Addison's disease

In this case report, we presented a case presenting with adrenal insufficiency, and which was thought to have sarcoidosis related involvement of adrenal gland in the etiology. A 68 years old female patient was diagnosed with sarcoidosis for having bilateral hilar lymphadenopathy, nodular lesions in the lungs, elevated serum angiotensin converting enzymes, and the colon and velum biopsies being concordant with noncaseified epitheloid granuloma. In addition, fatigue, weight loss, hyperpigmentation, hypotension, hyponatremia which had been continuing for four months until the admittance of the patient, suggested adrenal insufficiency. With the measurement of serum cortisol levels low and adrenocorticotropic hormone levels high in the further tests, the adrenal insufficiency diagnosis was established. After excluding other reasons of Addison's disease (autoimmune, tuberculosis, malignity, etc.), the adrenal insufficiency was thought to be related to sarcoidosis involvement.