Clinical Features of Addison's Disease (2) In acute adrenal failure occurring de novo (e.g. as with a septicaemia), the patient will not be pigmented and the symptoms will usually be weakness, malaise, nausea (often with vomiting), and non-specific or vague epigastic abdominal pain associated with constipation or diarrhoea. A cardinal physical sign is postural hypotension. In chronic adrenal insufficiency, many of the same features are present, but the presentation is much more vague. See later: • Facial Pigmentation in Addison's Disease • Vitiligo in Addison's Disease • Other Clinical Features in Addison's Disease