Adrenocortical insufficiency

Am J Forensic Med Pathol. 1999 Mar;20(1):60-5. doi: 10.1097/00000433-199903000-00015.


Primary adrenocortical insufficiency is a rare disease which may present with protean clinical symptoms and signs. At one end of the spectrum is the patient with a long clinical history with marked pigmentation and documented episodes of crises which may follow relatively minor viral illnesses. The other extreme is illustrated by patients with a rapid deterioration in health culminating in unexpected or unexplained death. In the latter instances, the forensic pathologist may well be involved, and the case will present a significant challenge to diagnosis. We report 5 cases of primary and secondary adrenocortical insufficiency seen at the Victorian Institute of Forensic Medicine in 1 year. One adult man presented as a case of sudden unexplained death. In 2 cases, the diagnosis of adrenocortical insufficiency was raised following postmortem examination and confirmed by the treating physician following further consultation. In the remaining 2 cases, the diagnosis was known prior to postmortem examination and the diagnosis confirmed.

Publication types

  • Case Reports

MeSH terms

  • Addison Disease / pathology
  • Adrenal Glands / pathology
  • Adrenal Insufficiency / blood
  • Adrenal Insufficiency / pathology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Death, Sudden / etiology
  • Female
  • Forensic Medicine
  • Humans
  • Hydrocortisone / blood
  • Lymphocytes / pathology
  • Male
  • Middle Aged


  • Hydrocortisone