<prompt> A man presents with weakness, pain in upper abdomen, hyperpignientation, arthritis, hyperglycemia and an enlarged palpable liver. Most probable diagnosis is:HaemochromatosisAddisons diseaseInsulin Dependent DMCushings syndrome  <response>: Ref: Harrisons Principles of Internal Medicine, 18ed.Explanation:HaemochromatosisOrgans commonly affected by haemochromatosis are the liver, heart, and endocrine glands. Haemochromatosis may present with the following clinical syndromes:Cirrhosis of the liverDiabetes due to pancreatic islet cell failureCardiomyopathyArthritis iron deposition in jointsTesticular failureTanning of the skinJoint pain and bone painAddisons diseaseAlso chronic adrenal insufficiency, hvpocortiso- lism, and hvpoadrenalism is a rare, chronic endocrine disorder in which the adrenal glands do not produce sufficient steroid hormones glucocorticoids and often mineralocorticoids.The symptoms of Addisons disease develop insidiouslyFatigue, LightheadednessMuscle weaknessFeverWeight lossAnxietyNausea, vomitingDiarrheaHeadacheSweatingChanges in mood and personalityJoint and muscle painsMarked cravings for salt or salty foods due to the urinary losses of sodiumIncreased tanning in sun-exposed areasDarkening of the palmar creases, sites of friction, recent scars, the vermilion border of the lips, and genital skin.Clinical signsLow blood pressure that falls further when standing iOrthostatic HypotensionMost people with primary Addisons have darkening hyperpignientation of the skin, including areas not exposed to the sunCharacteristic sites are:Skin creases of the handsNippleInside of the cheek buccal mucosaOld scars may darken.This occurs because melanocyte-stimulating hormone MSH and adrenocorticotropic hormone ACTH share the same precursor molecule, proopiomelanocortin POMC.After production in anterior pituitary gland. POMC gets cleaved into gamma-MSH. ACTH and beta-lipotropin.The subunit ACTH undergoes further cleavage to produce alpha-MSH, the most important MSH for skin pigmentation.Associated withType I diabetesThyroid disease Hashimotos thyroiditis and goiterVitiligoAutoimmune polyendocrine syndromeThe occurrence of Addisons disease in someone who also has Hashimotos thyroiditis is called Schmidt syndrome.Addisonian crisis Adrenal crisisConstellation of symptoms due to severe adrenal insufficiency.It is a medical emergency and potentially life- threateningCharacteristic symptoms are:Sudden penetrating pain in the legs, lower back or abdomenSevere vomiting and diarrhea, resulting in dehydrationHypotensionSyncopeHypoglycemiaConfusion, psychosis, slurred speechHyponatremiaHyperkalemia HypercalcemiaConvulsionsFever 