<prompt> After bilateral adrenalectomy, patient developed gradual loss of vision, with hyperpigmentation of skin, and headache. Likely cause isAddisons diseaseNelsons syndromeCushings diseaseHarrisons syndrome  <response>: In 10 of patients with Cushings disease who undergo a bilateral adrenalectomy after failed pituitary surgery, the pituitary adenoma causes Nelsons syndrome due to continued ACTH secretion at high levels, causing hyperpigmentation as a result of chemical synergies between ACTH and melanocyte-stimulating hormoneRef: Bailey and Love 27e pg: 842 