A 63-year-old man recently treated for renal tuberculosis presents with weight loss, diarrhea, hypoglycemia, hypotension, and is noted to have hyperpigmented buccal mucosa, palmar and hand creases. Which investigation is most suitable for this clinical presentation?
Ans. C Plasma ACTH and cortisolRef: CMDT 2019 page 323* The key finding of hyperpigmentation of buccal mucosa, palmar and sole creases point to etiology of Addison disease. The leading cause of Addison's disease in India is tuberculosis.* The presence of hypotension indicates hypoaldosteronism in Addison's disease. Simultaneous mention of hypoglycemia indicates cortisol deficiency.* Choice B is done in case of hemochromatosis and bronze diabetes* Choice C is done in case of Wilson disease* Choice D is done in for diagnosis of tuberculosis
Serum iron and ferritin
Serum copper and ceruloplasmin
Plasma ACTH and cortisol
Gene XPERT and Intravenous pyelography
Endocrinology and Reproduction