Clinical Aspects of the Chronic form of Primary Adrenocortical Failure (Addison’s Disease) in the Adult

Vandeput, Y.; Rahier, Jacques; Crabbé, J.

doi:10.1080/22953337.1979.11718706

Cited by 5 publications

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“…In the absence of stress, dehydration, or sodium deprivation the patients are relatively asymptomatic until over 90 per cent of their adrenal glands are destroyed 4 . They are particularly sensitive to sedating medications, diuretics, or anesthesia, and have a slow recovery or develop unexplained hypotension following a minor illness or surgery 5,6 . The clinical manifestations of AD are caused by mineralocorticoid and glucocorticoid deficiency and are the same for all ages 4,7 .…”

Section: Discussionmentioning

confidence: 99%

“…It may also be prominent on sunexposed areas, skin creases, and genitalia. In some elderly it will be a tan that never fades 1,5,6,9–12 …”

Section: Discussionmentioning

confidence: 99%

“…The usual maintenance dose of hydrocortisone is 20 mg in the morning and 10 mg at night. Some patients will have preservation of mineralocortical function 6,42 ; however, those without adequate reserve will require supplementation with 0.05 mg to 0.1 mg of fludrocortisone a day. In the elderly, replacement therapy may lead to hypertension (as occurred in our patient) or fluid overload.…”

Section: Discussionmentioning

confidence: 99%

“…In Guttman's extensive study of 566 cases of AD published in 1930, he found that 43 per cent of the patients died within six months 8 . Today, the prognosis is excellent with most patients having a normal life expectancy 6,47 …”

Section: Discussionmentioning

confidence: 99%

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Adrenal Insufficiency (Addison's Disease) in the Elderly

Moss

England

Kowal

1985

J American Geriatrics Society

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He was greatly anacmiated, his eyes were p c d y ; he complained of extreme languor and fiiintness; liis pulse . . . exquisitely soft and coinpressi1)lc; the iinpiilse of the heart was feeble . . . without pain, tlie stoniach w a s both urgent and distressing. . . . there were observed, chiefly on the face, neck and a r m , patches of a rather deep chestnut-brown colour . . .A patient inquiry and most careful examination fhiled to elicit any information, or to detect any lesions, sufficient to afford even a plausible explanation of the patient's siiigiilar condition. ' -Thoincis Addison's description of ci initldle-aged m i n with tirberciiloiis cidrennl iiisrifficieiicg (1855)'Addison's disease (AD) is a rare disorder that can be easily misdiagnosed in t h e elderly. hf any of t h e manifestations of AD occur frequently in the elderly such a s asthenia, anorexia, lethargy, gastrointestinal symptoms, confusion, weight loss, postural 11 y p o t e 11 s io n , p re re 11 a1 azo t e in ia, 11 y poll a t re 111 i a, and hyperlcalemia with renal insufficiency. The clinician should consider A D in an elderly patient if several of these findings are present, especially if they coexist with hypoglycemia, hyperpigmentation, Iiypotension, o r normotension in a previously hypertensive patient. Prompt treatment of AD is effective, whereas undiagnosed AD is uniformly fatal. We present a case of A D in a septagenurian and, review its incidence, etiology, clinical features, diagnosis, i1ntl therapy in t h e elderly.A 70-year-old black man liad 1)eeii in his usual good health until about eight months prior to admission, when he liad iioticed increasing fatigue, generalized weakness, and anorexia. Over tlie eight-month period, he lost ap-

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Section: Discussionmentioning

confidence: 99%

“…It may also be prominent on sunexposed areas, skin creases, and genitalia. In some elderly it will be a tan that never fades 1,5,6,9–12 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Adrenal Insufficiency (Addison's Disease) in the Elderly

Moss

England

Kowal

1985

J American Geriatrics Society

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“…1974], Indeed most cases are nowadays recognized as of an au toimmune nature, leading to involution of the adrenocortical tissue; there often are cir culating antibodies, of the IgG variety, di rected against it [Mornex and Pousset, 1971;Irvine, 1980], This general distinction applies to our series, since 30 cases are thought to belong to the group with immune disorders, for 15 with tuberculosis (3 of whom with residual adrenocortical function) [Vandeput et al, 1979], The idiopathic, autoimmune form affects younger, mainly female individuals who in our series outnumber male patients by a fac tor of 4. whereas the proportion is reversed among the cases with tuberculosis; further more, patients of the former group are usually younger at the onset of the disease, by 10 years on average in our series. Autoimmu nity is suspected when there is no evidence of tuberculosis and/or of calcifications in the suprarenal area demonstrable on X rays3, .…”

Section: Etiologymentioning

confidence: 91%

Associated Endocrine Disorders in the Chronic Form of Primary Adrenocortical Failure (Addison’s Disease)

Crabbé¹,

Vandeput²

1982

Horm Res

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Urinary catecholamine excretion in patients with secondary adrenocortical insufficiency

Mpoy

Kolanowski

1986

J Endocrinol Invest

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To evaluate the relationship between the secretion of cortisol and the activity of adrenal medulla in the secondary adrenocortical insufficiency, the excretion of epinephrine and norepinephrine was documented in 8 patients suffering from panhypopituitarism. Plasma levels and urinary excretion of cortisol were very low in baseline conditions, and the increase in these parameters of cortisol secretion occurring upon ACTH infusion was significantly reduced with respect to the response to ACTH documented in normal subjects. The mean value of urinary epinephrine excretion was at the lower limit of normal values, and a highly significant positive correlation was found between cortisolemia or cortisoluria and urinary epinephrine excretion in these patients. Despite a significant increase in cortisolemia and cortisoluria upon ACTH administration, this acute increase in adrenocortical activity was without any stimulatory effect on epinephrine or norepinephrine excretion. But, as in baseline conditions, a significant correlation was documented for the degree of adrenocortical activity and epinephrine excretion on the day of ACTH administration. It appears, therefore, that in severe secondary adrenocortical insufficiency the excretion of epinephrine is reduced proportionally to the decrease in adrenocortical activity.

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Clinical Aspects of the Chronic form of Primary Adrenocortical Failure (Addison’s Disease) in the Adult

Cited by 5 publications

References 0 publications

Adrenal Insufficiency (Addison's Disease) in the Elderly

Adrenal Insufficiency (Addison's Disease) in the Elderly

Associated Endocrine Disorders in the Chronic Form of Primary Adrenocortical Failure (Addison’s Disease)

Urinary catecholamine excretion in patients with secondary adrenocortical insufficiency

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Clinical Aspects of the Chronic form of Primary Adrenocortical Failure (Addison’s Disease) in the Adult

Cited by 5 publications

References 0 publications

Adrenal Insufficiency (Addison's Disease) in the Elderly

Adrenal Insufficiency (Addison's Disease) in the Elderly

Associated Endocrine Disorders in the Chronic Form of Primary Adrenocortical Failure (Addison&rsquo;s Disease)

Urinary catecholamine excretion in patients with secondary adrenocortical insufficiency

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Product

Resources

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Associated Endocrine Disorders in the Chronic Form of Primary Adrenocortical Failure (Addison’s Disease)