A 42 year old woman was admitted to the intensive care unit (ICU) for hypotension and confusion. Her medical history comprised autoimmune thyroiditis and Biermer’s disease. The patient rapidly developed multiorgan failure requiring mechanical ventilation, fluid loading, and noradrenaline (norepinephrine) infusion. All samples for bacteriological culture were negative. Serum cortisol level was 2 nmol/l …