Acute and chronic adrenal insufficiency in a patient showing polyglandular deficiency and acromegaly.

Abstract

THIS patient presented such unusual clinical features that the case merits reporting and discussion. The occurrence of acromegaly (inactive or “burnt out”)> and acute adrenal insufficiency is a rare combination to which there is scant reference in the literature (1, 2, 3, 4). CASE REPORT W.D. was a 41-year-old, unmarried, white, lumbermill foreman, who entered the hospital on February 17, 1949, in a state of semicoma. He had been well until fortyeight hours prior to admission when severe prostration developed and he lost his appetite. On the day of his admission he became irrational and semicomatose and had diarrhea. The past history later obtained from the patient and from members of his family was as follows: In 1932 he consulted a physician because of undue fatigability and was told that he had heart disease. At that time he had no other symptoms and the fatigability disappeared spontaneously. About 1936 there was loss of axillary hair and partial loss of pubic hair.