Eighty‐six cases of Addison's disease

Abstract

The calculated prevalence was 110 per million population. The cause was attributed to autoimmune destruction of the adrenal cortex in 81 (93%). There were two cases of metastatic malignancy and three unrelated cases of late onset adrenoleukodystrophy, but none were attributable to tuberculosis. Twenty-one new cases were diagnosed between 1987 and 1993. The calculated incidence was 5.6 per million per annum. The biochemical basis of the diagnosis was reviewed in these 21 patients and as a result firm criteria are suggested for the interpretation of the short Synacthen test; criteria for normality being baseline cortisol >250 and 30 minute peak >600 nmol/l, taking into account clinical circumstances.