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Use of adrenal biopsy in diagnosing adrenoleukomyeloneuropathy.

A 22-year-old man was seen with Addison's disease, psychosis, and neurologic abnormalities. A tentative diagnosis of adrenoleukomyeloneuropathy was made. Because of his age, negative family history, and the potentially serious prognosis of this disorder, the diagnosis was verified with an adrenal biopsy. We believe this procedure is the method of choice in confirming the sporadic, atypical case of adrenoleukomyeloneuropathy.

Addison Disease↗

Adrenal disorders in cats.

Although adrenal disorders are uncommon in cats, they are being recognized with increasing frequency. The low incidence and unique characteristics of adrenal disease in cats often make the diagnosis and treatment of these disorders challenging. This article summarizes information on the diagnosis and treatment of feline adrenal disorders, including hyperadrenocorticism, hypoadrenocorticism, pheochromocytoma, and hyperaldosteronism.

Adrenal Cortex Diseases↗

Adrenal hemorrhage in the adult.

Bilateral adrenal gland hemorrhage was found in 22 of 2,000 (1.1%) consecutive general hospital autopsies. Clinical features of these 22 patients with diffuse or focal bilateral adrenal hemorrhage have been analyzed and compared with previous series. In our experience, patients with this postmortem finding rarely manifest features of adrenocortical insufficiency and appear instead to die as a consequence of concomitant overwhelming illness, such as septicemia, body surface burns or cardiovascular catastrophe. Two-thirds of the current series had impaired renal function at the time of adrenal hemorrhage and three patients had pituitary gland necrosis. Experimental and clinical observations indicate that the "stressed" adrenal gland--under substantive endogenous or exogenous ACTH stimulation--is unusually susceptible to hemorrhage. While our own experience indicates that bilateral adrenal hemorrhage can infrequently be implicated as a factor contributing to patients' death, the possibility of adrenocortical insufficiency must be considered in patients at risk for adrenal hemorrhage. Such patients are those who are azotemic and have bacteremia, burns, or recent cardiovascular catastrophe, particularly when the latter is managed with anticoagulant administration. In these patients, unexplained clinical deterioration or the appearance of findings consistent with adrenocortical insufficiency mandate measurement of serum cortisol concentration and institution of stress-level corticosteroid replacement therapy until a diagnosis of acute adrenocortical insufficiency can be established or refuted.

Adrenal Cortex↗

[Tuberculosis of the contralateral adrenal gland: a case report].

Unilateral adrenal tuberculosis is a very rare disease. A 66-year-old woman presented with epigastric discomfort and general fatigue. Abdominal CT scan revealed a homogeneous mass shadow in the right adrenal region. Findings of physical examination were normal except that the patient was obese. Hormonal data were in normal range. Adrenal scintiscanning demonstrated no RI uptake in the right adrenal gland. Right adrenalectomy was performed under the diagnosis of nonfunctioning tumor of the right adrenal gland. Histopathological examination, however, revealed typical tuberculosis with Langhans' type of giant cells and infiltrated lymphocytes. Of 322, 148 autopsies performed during the twelve years between 1970 and 1981 in Japan, 228 cases of adrenal tuberculosis were recognized. Furthermore, only 18 cases had tuberculous regions in the adrenal gland alone.

Adrenal Gland Diseases↗