THE DIAGNOSIS OF ADDISON'S DISEASE

Although the typical case of Addison's disease can be recognized clinically, the laboratory becomes an indispensable aid in the diagnosis of those cases which do not entirely fit the ordinary picture. Realizing the serious prognosis implied in such a diagnosis, as well as the importance of evaluating the therapy, my associates and I have in doubtful cases employed the salt restriction test suggested by Harrop and his co-workers1for final diagnosis. In cases of Addison's disease during restriction of sodium chloride, signs of early relapse can be expected any time after the first day but usually somewhere between the third and the fifth. Characteristic concomitant alterations in the blood are lowering of the sodium and chloride, elevation of potassium and nitrogen, hemoconcentration and diminution in blood volume. An example of this is the case of T. M., in whom a typical addisonian crisis occurred on the fifth day following