Acquired primary endocrine failure in adult Ethiopian patients

Over a 4 year period, February 1986 to January 1990, 18 patients with acquired primary endocrine failure were seen in the weekly endocrine clinic of Tikur Anbessa teaching and referral hospital in Addis Abeba. Eight patients had hypothyroidism and 4 Addison's disease; 3 of the 5 hypothyroid and 2 of the 3 Addison's cases on whom autoantibodies were determined were positive. One patient had polyglandular failure, involving the adrenal and thyroid glands and the gonads. In one patient tuberculosis was the cause of Addison's disease and 2 patients each had hypothyroidism and hypoparathyroidism, respectively, following surgery. All the patients had clinical, hormonal and/or biochemical evidence of endocrine failure and all but the hypoparathyroid patients responded to the replacement therapy. There was one patient who had an unusual but confusing discordant hypothyroxinaemia and hypertriiodothyroninaemia who developed hypothyroidism during treatment for his Graves' disease; the hypothyroidism resolved when the medication was stopped. The results of this study indicate that autoimmune endocrine failure is probably not as rare as it was previously thought and hence further studies are recommended to find out if the incidence among Ethiopians is, indeed, similar to or different from the results in other African patients.