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Collagenous colitis in a patient with Addison's disease: a case report.

Diarrhea is a non-specific symptom which may be associated with Addison's disease and several causes had been demonstrated in the aetiology. We describe a patient with Addison's disease who was suffering from chronic diarrhea for three months. She was diagnosed as having collagenous colitis and successfully treated with Sulphasalazine, 2 g/day. Collagenous colitis is an uncommon cause of chronic diarrhea and the association of collagenous colitis with Addison's disease has not previously been described. We think that collagenous colitis may play a role in the aetiology of diarrhea in patients with Addison's disease and therefore we suggest a full colonoscopic examination in other patients with Addison's disease and diarrhea to determine the incidence of collagenous colitis in the aetiology of diarrhea.

Addison Disease↗

[Addison's disease in pregnancy (author's transl)].

A rare case of Addison's disease in pregnancy in a 20 year old gravida: 2 para: 0 is described. The patient was admitted at 31 weeks gestation with premature labor. The patient was on cortisone therapy for Addison's disease prior to the pregnancy. this was continued. Premature labor was stopped and a 2350 g. male infant was delivered at term. The prenatal and post-natal treatment is described. The seven most important points in treatment of Addition's disease during pregnancy are listed.

Addison Disease↗

CT findings of adrenal glands in patients with tuberculous Addison's disease.

The CT findings of adrenals in 18 cases of tuberculous Addison's disease are reported. All cases demonstrated bilateral adrenal involvement, 35 glands with active tuberculosis appeared enlarged and one with non-active tuberculosis showed an atrophic gland with calcification. Areas of non-enhancing necrosis in the enlarged adrenals were seen in 34 glands (17 cases), among them 19 glands showed peripheral rim enhancement. In the 35 enlarged adrenals 25 glands had preserved contours. Small calcification dots in the adrenals were seen in 7 glands with active tuberculosis (4 cases). The CT signs of active tuberculous adrenalitis associated with Addison's disease were enlarged glands associated with large necrotic areas, with or without dot-like calcification. When the contours of the adrenals were preserved, the diagnosis of infectious disease could be made with increased confidence. Tuberculous adrenalitis should not be excluded when the enlarged adrenal glands appear mass-liking. CT study of the morphological changes of adrenal glands on patients with Addison's disease might help to define the etiology of the disease and contribute to treatment planning.

Addison Disease↗

Liver involvement in Addison's disease.

Three patients admitted because of slightly increased serum aminotransferases were found to have Addison's disease. A review of 16 other patients with Addison's disease who had serum aminotransferase activity [aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT)] determined prior to treatment revealed one more patient with slightly increased aminotransferase activity that could not be explained by known causes of increased serum aminotransferase levels. In all four of these patients, the enzymes normalized within 1 wk of corticosteroid substitution treatment. Liver biopsy in one patient revealed discrete lymphocytic infiltrates in the portal zones. On the basis of these observations, we recommend that the possibility of Addison's disease should be considered in patients with obscure slight hypertransaminasemia.

Addison Disease↗

Addison's disease, psychosis, and the syndrome of inappropriate secretion of antidiuretic hormone.

A case of tuberculous Addison's disease presenting with psychosis, profound hyponatraemia, and detectable plasma antidiuretic hormone is reported. Clinical and biochemical improvement after corticosteroid replacement was followed by relapse with further psychosis and inappropriate antidiuretic hormone secretion: both were promptly reversed by demethylchlortetracycline. The association of psychological symptoms with Addison's disease, the role of anti-diuretic hormone secretion in Addison's disease, and the inter-relationship between Addison's disease, psychosis and anti-diuretic hormone secretion are discussed.

Addison Disease↗

Unusual presentation of Addison's disease in Schmidt's syndrome.

A patient with Schmidt's syndrome and atypical symptoms of Addison's disease is presented. Autoimmune thyroiditis was diagnosed at the age of 12 years and then at 15 years; a diagnosis of migraine was made following 10 days of headache, visual field defects and dysarthria. One week later the patient was admitted to hospital in critical condition. Addison's disease was diagnosed and replacement therapy was introduced which brought about a rapid clinical improvement. Positive adrenal autoantibodies confirmed the diagnosis. We suggest that patients with organ-specific autoimmune disease undergo annual screening for adrenal activity, and in the event of abnormal results, adrenal autoantibody evaluation should be carried out, to avoid a life-threatening crisis caused by Addison's disease, which is often difficult to recognize due to atypical clinical presentation, as in the patient reported here.

Acute Disease↗

Intractable hiccups--an early feature of Addison's disease.

Hiccups has not been previously reported as a manifestation of Addison's disease. We report two cases where persistent hiccups was an early feature of Addison's disease. Steroid replacement cured the symptoms in both patients with no recurrence.

Addison Disease↗