Addison's disease presenting with marked eosinophilia and psychosis.

A 48-year-old man was admitted with hypotension, hyperpigmentation, neuromuscular dysfunction and psychiatric symptoms. Serum sodium values were low and serum potassium values high. He had marked eosinophilia. A clinical diagnosis of Addison's disease was made. He initially responded satisfactorily to corticosteroid replacement but died suddenly at home. Postmortem examination showed miliary tuberculosis. The need to treat Addison's disease in the third world with antituberculous drugs even in absence of clear evidence of active tuberculosis is stressed.