Sudden Death and Enlarged Adrenal Glands in an Otherwise Healthy Adult Woman

Abstract

1. What are this individual’s most striking anatomic autopsy findings? 2. How do you explain these findings? 3. What is the most likely diagnosis consistent with this patient’s autopsy histopathologic findings? 4. What is the most common cause of Addison’s disease? 5. What laboratory testing can help confirm the diagnosis in this case or in a living patient? 6. What utility does a single, untimed, serum cortisol measurement have in evaluating Addison’s disease in a living patient? 7. Why were no tuberculosis (TB) organisms found in stained tissue sections from the decedent? 8. Based on the decedent’s most likely diagnosis, what increased risk is there to the decedent’s family and close contacts and to autopsy personnel? 9. Why did the decedent’s skin darken in the period immediately preceding her death?