Unraveling an Elderly Man’s Fatigue

An 83-year-old man presents with fatigue, weight loss, and orthostatic hypotension. Explore the Differential Diagnosis for hyponatremia and hyperkalemia.

Primary adrenal lymphoma


An 83-year-old man presented to the emergency department with a 6-week history of fatigue, loss of appetite, and weight loss. His blood pressure was 115/80 mm Hg while seated but dropped to 95/65 mm Hg on standing. Laboratory investigations demonstrated hyponatremia and hyperkalemia. What is the diagnosis?

What is the most likely diagnosis?

Abdominal tuberculosis
Primary adrenal lymphoma
Renal cell carcinoma metastases
Bilateral adrenal hyperplasia
Conn’s syndrome

Adrenal Insufficiency, Hyperkalemia, Hyponatremia, Orthostatic Hypotension, Primary adrenal lymphoma

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