nbme form 7, q 18, please help - lilndn2003

[ArchivalUser]

a 52 yr lady has weakness and weight loss, 20lb for 4 months. she has not traveled outside us. her bp is 80/ 50. her skin shows hyperpigmentation. plasma concentration of ACTH is markedly increased, and serum concentration of cortisol is decreased. ct of chest and abdomen show no mass lesions. what is etiology of disease?

a. autoimmune
b. congenital
c. infectious
d. metabolic
e. neoplastic

the answer is not neoplastic

any ideas guys? maybe this is obvious and im just blanking out

[ArchivalUser]

this seems to be addisons - primary adrenal insuff, because of the hyperpigmentation
not sure if the answer would be autoimmune or infectious though? i would think infectious because of neisseria, but on wiki it says this can be autoimmune.........if anyone knows, do share

[ArchivalUser]

AA autoimmune....even Goljan says dat most common cause of addisons is autoimmune(80%)

[ArchivalUser]

Chukles is right.

Autoimmune = most common cause of Addisons.