A 64-year-old man presented with general malaise, edema, and other nonspecific symptoms, prompting extensive diagnostic evaluation. The patient's early morning cortisol and adrenocorticotropic hormone levels were consistent with primary adrenal insufficiency without evident secondary or tertiary causes on magnetic resonance imaging. The interferon gamma release assay (T-SPOT) was positive, suggesting latent tuberculosis, although there were no signs of active tuberculosis.
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