ADDISON'S DISEASE FOLLOWED FOR NINE YEARS: CASE REPORT WITH AUTOPSY

Abstract

A case is reported of a 41 yr. old cf who had been followed for 9 yrs. and who had symptoms of Addison''s disease for 10 yrs. A change in pigmentation, previously unnoticed, occurred within 6 mos. after therapy with adrenal cortex extract and salt. Over a period of 9 yrs. there was a pronounced loss of pigment. No claim is made that therapy was responsible for this. Several Addisonian crises occurred, requiring an increase in treatment dosage. Failure to take treatment for 2 wks. resulted in a crisis from which he did not recover. Exitus was preceded by delirium, fever, and hypoglycemia (blood sugar 32 mg.). At autopsy, no adrenal tissue was found anywhere. The pituitary showed diffuse fibrosis of the anterior lobe with curious acinar development and acinar cells showing a basophilic cast; no changes in the pars intermedia; and a thickened capsule of the pars nervosa. The thyroid showed extreme exhaustion with degenerating fibrosis. The pancreas had plenty of insular tissue. The testes were small grossly but normal morphologically. The heart was small and showed general atrophy.