Hospital staff must be more aware of the catastrophic dangers of the rare Addison's disease going undetected, a NSW coroner has warned.
Sydney residents Jessica Martin, 24, and Peter Domachuk, 33, died from the disease three years apart, each just days after being discharged from hospital where it was not diagnosed.
Addison's disease affects about one in every 100,000 people with symptoms including fatigue, weight loss, joint pain and nausea.
The disease can lead to critically low levels of cortisol flowing to body organs and affect blood pressure and inflammation.
Dr Domachuk went to hospital in December 2012 complaining of joint and abdominal pain, nausea and vomiting.
He was discharged two days later after his skin colour, appetite, mobility and lethargy improved.
But he died inside his Thornleigh unit days after his release.
Deputy State Coroner Carmel Forbes said on Wednesday that just one medical registrar suspected Addison's disease may have been causing Dr Domachuk's ailments, but this was not documented and was poorly communicated between hospital staff.
A cortisol test was performed that may have detected the disease but was not reviewed until after Dr Domachuk's release from hospital.
A heart attack in the presence of Addison's disease and coronary artery disease was his probable cause of death, Ms Forbes said.
Ms Martin died of a heart attack in July 2009 days after being released from hospital where she had been admitted with chest pains.
Ms Forbes said there was nothing inappropriate about Ms Martin's medical care and treatment, but more could be done to prevent similar deaths.
She said medical practitioners needed to be reminded to think about the possibility of the uncommon condition.
"I recommend that the NSW Ministry of Health consider publishing a patient safety watch to local health districts with the aim of increasing awareness of the potentially catastrophic outcome of undiagnosed adrenal insufficiency, Addison's disease," Ms Forbes said.
