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Musculoskeletal aspects of hypoadrenalism: just a load of aches and pains?

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Abstract

Musculoskeletal signs and symptoms of hypoadrenalism are less well described in the literature compared to other endocrine disorders such as diabetes mellitus and thyroid disease. This may in part be due to the difficulties associated with making a definitive diagnosis of hypoadrenalism where the general symptoms and signs can be very subtle. Hence, suspecting hypoadrenalism in a patient with mainly musculoskeletal features can be difficult and delayed. To illustrate this point, we present three cases of hypoadrenalism with varying degrees of rheumatological symptoms and signs. This article reviews all the cases of hypoadrenalism in the English, French and Spanish language medical literature, going back to the time of Thomas Addison. All the important clinical and laboratory features have been summarised to help clinicians diagnose and treat this disease.

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Acknowledgement

Thank you to Mr. Rajeev S. Sathi for providing language translation services.

Disclosures

None.

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Authors and Affiliations

  1. Department of Rheumatology, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, WN6 8EP, UK

    N. Sathi, D. Swinson & C. Chattopadhyay

  2. Department of Rheumatology, James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Gorleston, Great Yarmouth, Norfolk, NR31 6LA, UK

    D. Makkuni

  3. Department of Rheumatology, Furness General Hospital, Dalton Lane, Barrow in Furness, LA14 4LF, UK

    W. S. Mitchell

Authors
  1. N. Sathi
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  2. D. Makkuni
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  3. W. S. Mitchell
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  4. D. Swinson
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  5. C. Chattopadhyay
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Corresponding author

Correspondence to N. Sathi.

Appendix

Appendix

Primary adrenal insufficiency cases [2–19]

Secondary adrenal insufficiency cases [6, 20–36]

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Sathi, N., Makkuni, D., Mitchell, W.S. et al. Musculoskeletal aspects of hypoadrenalism: just a load of aches and pains?. Clin Rheumatol 28, 631–638 (2009). https://doi.org/10.1007/s10067-009-1126-y

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  • DOI: https://doi.org/10.1007/s10067-009-1126-y

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