This unusual case combines acute onset Addison disease, adrenal hemorrhage, and APS. General languor and debility, feebleness of the heart’s action, irritability of the stomach, and a peculiar change of the color of the skin form part of the original description of Addison disease, primary hypoadrenalism. When it presents nonacutely, Addison disease represents a diagnostic challenge for the clinician; it has a notoriously nonspecific presentation and can be fatal. Addison disease is believed to be rare, but recent epidemiologic studies have reported a rising prevalence in developed countries, 93 to 140 per million, with an incidence of 4.7 to 6.2 per million. Autoimmune adrenalitis is the most common cause of adrenal failure, accounting for approximately 80% of the cases, followed by TB (15%). The remaining 5% of causes (which includes APS) are uncommon. Although APS is a rare cause, the acute onset helped with the diagnostic challenge in this case.