Chronic Pyelonephritis Simulating Adrenocortical Insufficiency

Abstract

THE clinical picture of a shock-like state presenting signs and symptoms indistinguishable from those of adrenal insufficiency may occur in patients with chronic renal disease with normal adrenal glands. This was first noted by Thorn, Koepf and Clinton in 1944¹ and by Sawyer and Solez in 1949.² The former group had observed 2 cases, the latter 1. This report is the third to appear in the literature and represents the fourth such case.This particular entity, named "salt-losing nephritis" by Thorn, is not to be confused with nephritis coexisting with adrenal cortical insufficiency.³ It must also be appreciated that Addison's . . .