Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 4 1 2010 03 15 31 34 Shahrbanou Keyhanian Hematology-Oncology Department, Azad-e-Eslami University of Medical Sciences, Tonekabon, Mazandaran, Iran Zahra Fotokian Midwifery and Nursing School, Babol University of Medical Sciences, Ramsar, Mazandaran, Iran Mohammad Mansour Saravi Radiology Department, Imam Sajjad Hospital, Ramsar, Mazandaran, Iran Houman Ghoreyshi School of Medicine, Azad-e-Eslami University of Medical Sciences, Tonekabon, Mazandaran, Iran 2015 10 01 Primary adrenal insufficiency (Addison’s disease) is due to adrenocortical disease. This study is about a 40 year old man who had been referred to a hematologist who assessed him for anemia. He  had been affected by a periodic paresthesia one month prior to his visit to the physician. According to the clinical presentation, macrocytic anemia and hypersegmentation of PMN in PBS, BMA/B was performed, which reported “megaloblastic anemia”. In 2001, his skin became mildly hyperpigmented, on the elbows, hands, groin and knees. In 2002, he felt weakness, had the sweats, arthralgia and myalgia. The patient was refered to a clinic and then to a hospital. But, his symptoms did not abate, therefore he was refered to the Imam-khomeini Hospital located in Tehran, and was admitted. At the hospital, new signs were detected: hypotension, hyponatremia (Na=100), raised ALT and TSH levels, and macrocytic anemia.The physician suspected primary adrenal insufficiency. More tests were performed and the diagnosis of Addison’s disease was confirmed. Noticing one of the rare features in Addison’s disease is megaloblastic anemia. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/239 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/239/232