Addison được chẩn đoán ở phụ nữ ở độ tuổi 52 này. Triệu chứng của cô bao gồm ói mửa, sụt cân, và điểm yếu tiến bộ. Cô đã bị suy dinh dưỡng, và huyết áp tâm thu máu của mình 98mmHg với huyết áp tâm trương 70mmHg. | 253 Figure Addison s disease was diagnosed in this woman at age 52. Her symptoms included vomiting weight loss and progressive weakness. She was malnourished and her systolic blood pressure was 98mmHg with a diastolic pressure of 70mmHg. There was considerable brownish pigmentation of the skin especially marked in the creases and over the elbows and knuckles. She responded very well to treatment with desoxycorticosterone acetate DOCA and was discharged 1 month later. She was then maintained with implantation of DOCA pellets and testosterone therapy. Three and one-half years later she was readmitted because of psychotic behavior but was discharged after unsuccessful attempts to alter the psychosis by hormone and electrolyte manipulation. A. The electrocardiogram shows a normal sinus rhythm at a rate of 100 complexes per minute low T waves in leads I and II and in precordial leads V2 through V6 and a QT duration of second the upper limit of normal for this heart rate is second . The QRS complexes are rather low in amplitude. B. The electrocardiogram taken 9 days after the one reproduced in part A shows a normal sinus rhythm at a rate of 75 complexes per minute. The T waves are sharp and peaked and the QRS complexes are rather low in amplitude. The duration of the QT interval measures second the upper limit of normal is second for this heart rate . Summary The tracing in A which was taken 17 days after admission following a long period of treatment with DOCA and testosterone is consistent with but not diagnostic of a low-potassium effect. The serum sodium level on that date was mEq L and the serum potassium level was mEq L. The latter was initially questioned because the patient had been taking potassium chloride by mouth for 10 days. It was later thought to represent a true value. The tracing in B shows the changes of early hyperkalemia. The serum potassium level 2 days prior to this recording was mEq L. This series of changes .
