Adrenocortical insufficiency.
Primary adrenocortical insufficiency is a rare disease which may present with protean clinical symptoms and signs. At one end of the spectrum is the patient with a long clinical history with marked pigmentation and documented episodes of crises which may follow relatively minor viral illnesses. The other extreme is illustrated by patients with a rapid deterioration in health culminating in unexpected or unexplained death. In the latter instances, the forensic pathologist may well be involved, and the case will present a significant challenge to diagnosis. We report 5 cases of primary and secondary adrenocortical insufficiency seen at the Victorian Institute of Forensic Medicine in 1 year. One adult man presented as a case of sudden unexplained death. In 2 cases, the diagnosis of adrenocortical insufficiency was raised following postmortem examination and confirmed by the treating physician following further consultation. In the remaining 2 cases, the diagnosis was known prior to postmortem examination and the diagnosis confirmed.
Burke
M P
MP
Victorian Institute of Forensic Medicine, Southbank, Australia.
Opeskin
K
K
D000224:Addison Disease / Q000473:pathology; D000311:Adrenal Glands / Q000473:pathology; D000309:Adrenal Insufficiency / Q000097:blood / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003645:Death, Sudden / Q000209:etiology; D005260:Female; D005554:Forensic Medicine; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged
D006854:Hydrocortisone