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THE DIAGNOSIS AND TREATMENT OF ADDISON'S DISEASE
Author(s) -
HUDSON BRYAN
Publication year - 1959
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1959.8.3.182
Subject(s) - medicine , addison's disease , fludrocortisone , adrenal insufficiency , cortisone , disease , pediatrics , occult , adrenal crisis , orthostatic vital signs , differential diagnosis , hydrocortisone , anorexia , blood pressure , pathology , alternative medicine
Summary Experience with 21 patients suffering from Addison's disease is described. Twenty patients are alive and able to lead active and normal lives. One patient died in Addisonian crisis at the time of diagnosis. The presenting symptoms and signs of the patients have been analysed. These patients have been drawn from a larger series of 41 cases in which the diagnosis of adrenal insufficiency was suspected. The conditions with which Addison's disease is commonly confused include : states of malabsorption, occult malignant disease, chronic renal disease, anorexia nervosa, other anxiety states, and orthostatic hypotension. Recent laboratory procedures have simplified the problems of differential diagnosis. The value of various diagnostic investigations is discussed, and the need for ACTH stimulation in diagnosis is stressed. Examples are cited of the application of the different procedures in diagnosis to patients in this series. An analysis has been made of the cause of the disease. This shows that the incidence of tuberculosis has become conspicuously less. Treatment of patients is outlined and discussed. All patients have been successfully maintained on cortisone or hydrocortisone for periods of up to six years. Eight patients receive mineralocorticoid supplement. It is concluded that the outlook for the patient with Addison's disease has improved with the introduction of newer methods for diagnosis, particularly ACTH stimulation, and with the availability of cortisone or hydrocortisone for treatment.