Addison’s disease with polyuria, amyloidosis and necrotising ulceration of the intestine

Summary

A case of Addison’s disease is reported which had not been seen or treated till the terminal stage of the illness. He came into hospital in collapse after a two-weeks illness marked by vomiting and diarrhoea.

The unusual features observed during the two days during which the patient was under observation were a striking polyuria in spite of very low serum electrolyte levels, a low urinary output of sodium, a low serum potassium and intestinal distension of a type resembling paralytic ileus.

The interesting post-mortem observations were advanced pulmonary tuberculosis, extensive visceral amyloidosis with complete replacement of both adrenals by amyloid and extensive necrotising ulceration of the intestines. The kidneys were healthy.