Education and debate

Lesson of the Week: Addison's disease

St Helier Hospital, Carshalton, Surrey SM5 1AA CM Brosnan, registrar in anaesthetics. Royal Marsden Hospital, London SW3 6JJ NFC Gowing, emeritus professor of pathology. Correspondence to: Dr Brosnan.

Primary adrenocortical insufficiency (Addison's disease) is a rare disorder in which there is destruction of the adrenal cortex, thus reducing the production of glucocorticoid, mineralocorticoid, and sex steroids.^{1 2} Most cases are now due to autoimmune disease³ and occur more often in patients with an HLA-DR3 and HLA-B8 tissue type. The disease may be associated with other immune disorders, including thyroid disease, diabetes mellitus, pernicious anaemia, hypoparathyroidism, and ovarian failure. We report two fatal cases of autoimmune Addison's disease that were diagnosed only at necropsy.

Case reports CASE 1

A 26 year old man was admitted to hospital with a history of two to three days of nausea and vomiting and increasingly frequent watery stools. He had also complained of a sore throat for two to three days, for which his family doctor had prescribed pivampicillin. He had not travelled overseas nor had he eaten any food outside his . . . [Full text of this article]

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