Clinical review of 20 cases of Addison's disease in Korea--including previously reported cases and 6 new cases at the National Medical Center.

Addison’s disease is a rare disorder resulting from a chronic deficiency of adrenol cortical hormone. The clinical manifestations and data of 20 patients with Addison’s disease were reviewed. They include 14 previously reported cases, total cases in korea upto 1987, and 6 new cases at National Medical Center. 1. 13 patients were male and 7 female. The mean age was 39 years and ranged from 16 to 61 years. 2. Common symptoms included mucocutaneous pigmentation (95 %), general weakness (90%), nasuea and/or vomiting (80%), and weight loss (60%). 3. Initial mean blood pressure was 96±21/63±14 mmHg and adrenal crises were found in 5 cases (25%). 4. Laboratory data indicated hyponatremia and hyperkalemia, resulting in a decreased Na/K ratio. Serum basal cortisol and ACTH levels were 2.86±1.93 ug/dl and 482.5/269.3 pg/ml, respectively. 5. Extra-adrenal tuberculosis was present in 14 cases (70%) as a very high incidence. 6. These 14 cases (70%) were presumed to be due to adrenal tuberculosis, although only two cases were confirmed as such by histopathology. The other cases were likely to be non-tuberculous. Thus, tuberculosis may be-considered as a predominant cause of Addision’s disease in Korea. Other features were not unusual. But further detailed and extensive studies are necessary including more pathologically confirmed cases.