SUPRARENAL CORTICAL INSUFFICIENCY AND CYTOTOXIC CONTRACTION OF THE SUPRARENALS

A disease of the suprarenals exists which is even rarer than tuberculosis of the suprarenals and may cause a clinical syndrome closely resembling Addison's disease. This disease is most commonly spoken of as atrophy of the suprarenal glands.¹ Brenner² calls it atrophy of the cortex; Roessle,³ inflammatory atrophy. The use of such terms as "essential adrenal insufficiency"⁴ signifies that the nature of this disease is not fully understood. In reviewing the literature, one gains the impression that there are apparently two entirely different diseases of the suprarenals leading to end stages which, on superficial examination at least, are confusing. Kovacs⁵ and more recently Omelskyj⁶ have differentiated strictly between changes purely inflammatory in nature and primary degenerative changes leading to necrosis and disappearance of the cortical cells. The inflammatory lesions of the suprarenals involve both the cortex and the medulla and are often brought about