Addison's disease, adrenal autoantibodies and computerised adrenal tomography

The present study describes 53 patients with Addison's disease, who attended Auckland hospitals between 1971-1980, 32 of whom presented for the first time during this period, when the mean annual incidence of Addison's disease was 4.5 cases/million population, and the respective frequency of idiopathic (auto-immune) and tuberculous aetiologies was 92 percent and 4 percent for caucasians, but 25 percent and 63 percent for Polynesians. In addition, adrenal reserve was tested by ACTH stimulation in 20 clinically non-Addisonian patients in whom circulating adrenal antibodies had been incidentally demonstrated and present for periods of up to six years, and was normal in all cases. Such antibodies therefore lack functional disease specificity. The diagnostic value of CT adrenal scanning in illustrating the contrasting appearances between tuberculous and auto-immune adrenalitis is shown in four patients.