Abstract
Adrenal insufficiency (AI) is a potentially life-threatening condition, predominantly affecting women of reproductive age. The clinical and biochemical diagnosis of new-onset AI in pregnancy is challenging due to the overlap with normal symptoms of pregnancy as well as pregnancy-induced changes in serum cortisol values. We describe the clinical presentation of a 31-year-old pregnant woman with type 1 diabetes mellitus who presented with severe nausea and vomiting. The diagnostic dilemmas involved in the workup of a pregnant patient with suspected AI in the context of normal fetoplacental steroidogenesis are highlighted. We conclude with a discussion of the management of AI in pregnancy. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2008, 2015, 2022