PubMed · 128397
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P Sheridan, C F Murray-Leslie, J R Golding. 1976-01-10. Addison's disease presenting with chronic low backache.. https://doi.org/10.1136/bmj.1.6001.77
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Adrenal computed tomographic (CT) scanning was conducted in twelve patients with Addison's disease during the clinical course. In tuberculous Addison's disease (n = 8), three of four patients examined during the first two years after disease onset had bilaterally enlarged adrenals, while one of four had a unilaterally enlarged one. At least one adrenal gland was enlarged after onset in all six patients examined during the first four years. Thereafter, the adrenal glands may atrophy bilaterally, in contrast to adrenal glands in idiopathic Addison's disease, which atrophy bilaterally from disease onset (n = 2). Adrenal calcification was a less sensitive clue in tracing pathogenesis, i.e., adrenal calcification was observed in five of eight patients with tuberculous Addison's disease, but not in idiopathic patients. Thus, adrenal CT scanning could show the etiology of Addison's disease (infection or autoimmunity) and the phase of Addison's disease secondary to tuberculosis, which may be clinically important for initiating antituberculous treatment.
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Pathologic organ specific autoimmune disease frequently affect endocrine glands and mostly lead to an insufficiency of the organs involved. Immunoendocrine diseases often occur in a polyglandular fashion and are consequently termed autoimmune polyglandular syndromes or immunoendocrinopathy syndromes. Among the different types one of the most frequent is known as Schmidt's syndrome or typus tyreosuprarenalis. Two case reports typical for this syndrome are described from a clinical point of view indicating also the respective diagnostics.