SIMMONDS' DISEASE (CACHEXIA HYPOPHYSEOPRIVA)

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Abstract
Simmonds' disease may be defined as a clinical state, most common in women, characterized by progressive, extreme emaciation, premature aging, wrinkling of the facial skin, loss of pubic and axillary hair, dental caries and loss of libido and sexual function, accompanied by a depression of the basal metabolic rate. Untreated, it is a progressively fatal disease, usually terminating suddenly with a short period of coma. There are often mental disturbances closely simulating Korsakoff's syndrome, so that the patients are sometimes first seen by the psychiatrist. The pathologic basis for the condition is varied. In general, it may be said that any process that destroys the anterior lobe of the pituitary gland may give rise to the clinical picture. A "splanchnomicria," an abnormal smallness of the viscera, is the only constant postmortem observation aside from changes in the pituitary body. This was first pointed out by Simmonds.1 Some idea of

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