Addison's disease

doi:10.1136/bmj.b2385

Published 2 July 2009, doi:10.1136/bmj.b2385
Cite this as: BMJ 2009;339:b2385

Practice

Easily Missed?

Addison’s disease

Bijay Vaidya, consultant endocrinologist, honorary senior clinical lecturer¹^,2, Ali J Chakera, specialist registrar¹, Catherine Dick, general practitioner³

¹ Department of Endocrinology, Royal Devon and Exeter Hospital, Exeter EX2 5DW, ² Peninsula Medical School, Exeter , ³ Devon Primary Care Trust, Topsham Surgery, Exeter EX3 0EN

Correspondence to: B Vaidya, bijay.vaidya@pms.ac.uk

doi:10.1136/bmj.b2384

The first 150 words of the full text of this article appear below.

A 34 year old woman presented with a 12 monthhistory of increasing tiredness, anorexia, weight loss, anddepression. During that period, she had tried two differentantidepressant tablets without benefit. She saw her generalpractitioner’s locum, who thought she looked tanned. Herblood pressure was 90/60 mm Hg, although it had always tendedto be low. Her serum sodium concentration was 130 (normal range135-145) mmol/l and potassium concentration was 5.7 (normalrange 3.5-5.5) mmol/l. A short Synacthen (tetracosactide) testshowed an inadequate serum cortisol response, which togetherwith raised plasma adrenocorticotrophic hormone confirmed thediagnosis of Addison’s disease.

Addison’s disease (also known as primary adrenal insufficiency)is a chronic disorder of the adrenal cortex resulting in inadequatesecretion of glucocorticoid and mineralocorticoid. The commonestcause of Addison’s disease in developed countries is autoimmunedisorder and in developing countries is tuberculosis.¹

Addison’s diseasehas a prevalence of 93-140 per . . . [Full text of this article]

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Addison’s disease: Sarah J K Baker and John A H Wass
BMJ 2009 339: b2384. [Extract] [Full Text]

Lesson of the week: Deterioration of symptoms after start of thyroid hormone replacement: Jonathan Stephen Murray, Rubaraj Jayarajasingh, and Petros Perros
BMJ 2001 323: 332-333. [Extract] [Full Text] [PDF]

My Addison's disease: Kathleen Hilditch
BMJ 2000 321: 645. [Full Text]

Lesson of the Week: Addison's disease: C M Brosnan and N F C Gowing
BMJ 1996 312: 1085-1087. [Extract] [Full Text]

Rapid Responses:

Read all Rapid Responses

Addison's disease: failure to diagnose can be fatal: Katherine G White, et al.
bmj.com, 24 Jul 2009 [Full text]
Adrenal Disease - Personal Experience: Gabriel Antony
bmj.com, 24 Jul 2009 [Full text]
Authors Response: Ali J Chakera, et al.
bmj.com, 18 Aug 2009 [Full text]