Hyperadrenocorticism. Reversibility of physiological and clinical changes associated with early hyperadrenocorticism treated by total adrenalectomy.

Abstract

Eighteen patients were treated for hyperadrenocorticism during its early stages by total adrenalectomy. In 14 of the patients the most significant problem before operation was cardiovascular deterioration; 9 of them had hypertension and 5 had congestive heart failure. The other four patients were women with progressive masculinization. Time elapsed since adrenalectomy varied from 12 to 35 months. The most significant improvement was the arrest of progressive cardiovascular damage. All patients demonstrated a decrease in osteoporosis; weakness was improved in all but four, and only one patient continued to demonstrate the moon face. There have been six episodes of addisonian crises. These were recognized early and treated adequately. All but one patient showed marked subjective improvement, especially a decrease in nervousness and emotional lability. There has been a significant reduction in hirsutism in the female patients. The long-term follow-up data on these 18 patients indicate the feasibility of total adrenalectomy for hyperadrenocorticism in the early stages.