title: Clinical significance of adrenal computed tomography in Addison's disease.
abstract: Adrenal computed tomographic (CT) scanning was conducted in twelve patients with Addison's disease during the clinical course. In tuberculous Addison's disease (n = 8), three of four patients examined during the first two years after disease onset had bilaterally enlarged adrenals, while one of four had a unilaterally enlarged one. At least one adrenal gland was enlarged after onset in all six patients examined during the first four years. Thereafter, the adrenal glands may atrophy bilaterally, in contrast to adrenal glands in idiopathic Addison's disease, which atrophy bilaterally from disease onset (n = 2). Adrenal calcification was a less sensitive clue in tracing pathogenesis, i.e., adrenal calcification was observed in five of eight patients with tuberculous Addison's disease, but not in idiopathic patients. Thus, adrenal CT scanning could show the etiology of Addison's disease (infection or autoimmunity) and the phase of Addison's disease secondary to tuberculosis, which may be clinically important for initiating antituberculous treatment.
authors.affiliation: Department of Medicine, Tokyo Women's Medical College, Japan.
authors.forename: Z H
authors.initials: ZH
authors.lastname: Sun
authors.forename: K
authors.initials: K
authors.lastname: Nomura
authors.forename: S
authors.initials: S
authors.lastname: Toraya
authors.forename: M
authors.initials: M
authors.lastname: Ujihara
authors.forename: N
authors.initials: N
authors.lastname: Horiba
authors.forename: T
authors.initials: T
authors.lastname: Suda
authors.forename: T
authors.initials: T
authors.lastname: Tsushima
authors.forename: H
authors.initials: H
authors.lastname: Demura
authors.forename: A
authors.initials: A
authors.lastname: Kono
mesh_terms: D000224:Addison Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D000311:Adrenal Glands / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D001284:Atrophy; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use; D013307:Streptomycin / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy
chemical_list: D007538:Isoniazid; D012293:Rifampin; D006854:Hydrocortisone; D013307:Streptomycin