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At least 487 records · Page 27Linked to original sources
PubMed2001

A critical evaluation of signs and symptoms in the diagnosis of Addison's diseases.

OBJECTIVES: To determine the usefulness of clinical symptoms and signs in the diagnosis of Addison's disease. METHODOLOGY: A retrospective, hospital based study from analysis of case records of over 12 years period (1988-1999). Individual or groups of signs and symptoms in 66 patients of confirmed Addison's diseases were compared with 76 subjects with normal ACTH stimulation test, when clinical presentations were similar. RESULTS: Age spectrum of the two groups was similar. Signs and symptoms like weakness, weight loss, gastro-intestinal disturbances, skin/mucosal pigmentation and blood pressure were not statistically different between the two groups. Similarly blood glucose, sodium and potassium were not different between the two groups. Combination of three or more symptoms/signs had a high predictive value of diagnosing the disease than any individual or a combination of < 3 signs/symptoms (P=0.033). CONCLUSIONS: Combination of skin and mucosal pigmentation with gut disturbances and weight loss carried high predictive value in diagnosis of Addison's disease, while individual sign and symptom has poor differentiating value.

Addison Disease↗
PubMed2000

Addison's disease in type 1 diabetes presenting with recurrent hypoglycaemia.

Primary adrenal insufficiency (Addison's disease) often develops insidiously. Although a rare disorder, it is more common in type 1 diabetes mellitus. A 19 year old male with type 1 diabetes and autoimmune hypothyroidism experienced recurrent severe hypoglycaemia over several months, despite a reduction in insulin dose, culminating in an adrenal crisis. Recurrent severe hypoglycaemia resolved after identification and treatment of the adrenocortical insufficiency. In type 1 diabetes, undiagnosed Addison's disease can influence glycaemic control and induce severe hypoglycaemia.

Addison Disease↗
PubMed1993

Adrenocorticotropic hormone receptor-blocking immunoglobulins in serum from patients with Addison's disease: a reexamination.

The presence of antibodies inhibitory to ACTH-stimulated cortisol secretion was investigated in patients with Addison's disease. In preliminary experiments, immunoglobulin G (IgG) samples from patients with Addison's disease and control subjects were prepared using diethylaminoethyl-cellulose ion exchange chromatography. Twelve of 29 Addison's IgGs and 1 of 3 control IgGs inhibited ACTH-stimulated cortisol secretion in an in vitro guinea pig adrenal cell bioassay. All but 1 of the samples that inhibited ACTH-stimulated cortisol secretion also inhibited dibutyryl cAMP-stimulated steroidogenesis. IgGs purified by protein-G immunoaffinity were similarly screened for inhibition of ACTH-stimulated cortisol secretion; samples from 5 controls and 5 patients with Graves' disease were without effect, and IgGs from only 2 of 25 patients with Addison's disease decreased ACTH bioactivity (by < 12%). The effects of the IgGs on ACTH bioactivity in vitro were not concentration dependent. Our results suggest that Addison's disease is not caused by circulating antibodies to the ACTH receptor. The inhibitory effects seen with IgG prepared by diethylaminoethyl ion exchange chromatography were most likely attributable to the effects of non-IgG components in the preparations.

Addison Disease↗
PubMed1982

ACTH-producing pituitary adenomas in Addison's disease: two cases treated by transsphenoidal microsurgery.

In 2 women with known Addison's disease, progressive hyperpigmentation reappeared years after an initial remission under conventional substitution therapy with cortisone. Excessively elevated plasma ACTH concentrations and radiological evidence of sella turcica deformation led to the diagnosis of ACTH-producing adenomas and prompted their removal by transsphenoidal microsurgery. In one patient, a large Crooke's cell adenoma with extensive extrasellar expansion had caused severe and irreversible bilateral defects of the visual fields and unilateral optic atrophy. Surgical removal of the tumour and radiotherapy brought about a permanent disappearance of the hyperpigmentation, but eventually led to secondary hypothyroidism. In the second patients, the selective removal of a small intrasellar eosinophilic adenoma consisting of ACTH-producing cells did not alleviate the hyperpigmentation and did not lower the plasma ACTH concentration. However, hyperpigmentation regressed markedly within a year of treatment with a higher dose of cortisone. The rarity of similar cases in the literature seems to indicate that insufficient feedback suppression of ACTH-producing cells in treated Addison's disease does not by itself induce the development of a pituitary adenoma, but might promote the growth of an independently and coincidentally occurring microadenoma, which would have caused Cushing's disease in a person with intact adrenal glands.

Addison Disease↗
PubMed1988

Addison's disease and empty sella.

A 47-year-old woman affected by Addison's disease, inadequately treated with corticosteroids for 14 yr, was referred to our clinic. As a x-ray of skull revealed an enlarged sella turcica, a more thorough study of hypothalamic-pituitary function and of the sellar region was performed. The normal suppression of high plasma ACTH levels induced by hydrocortisone infusion and the normal pattern of ACTH, TSH, PRL, LH and FSH to appropriate stimuli (CRH, TRH, GnRH) excluded the possible existence of an ACTH-secreting adenoma; the CT scan images showed the presence of an empty sella. The impaired GH rise after GHRH may be attributed to either the empty sella or the adrenal failure. This is the first patient with Addison's disease and empty sella, in whom the hypothalamic-pituitary function has been studied by the administration of four releasing hormones.

Addison Disease↗
PubMed1987

A clinical study of Addison's disease.

Fifty-four patients affected by primary adrenocortical insufficiency have been retrospectively studied. Eighteen were affected by a tuberculous Addison's disease, 24 by an idiopathic Addison's disease and 12 by an unclassifiable form. Modality of arise, clinical presentation and association with other diseases are reviewed. The most useful laboratory and instrumental tests for the diagnosis are discussed and a diagnostic flow-chart is proposed.

Addison Disease↗