In Addison disease, how does adrenal size typically change during disease progression?

In Addison disease, how does adrenal size typically change during disease progression?

• A. Enlarged in acute phase, small in chronic
• B. Always enlarged
• C. Always small
• D. No consistent change

Answer: (A)

In Addison disease, the adrenal glands reflect the disease stage. Early auto­immune inflammation can make the glands appear enlarged on imaging due to edema and lymphocytic infiltration. As the disease becomes chronic and the cortex is progressively destroyed, the glands undergo atrophy and shrink. So the typical pattern is enlarged in the acute/early phase, then small or atrophic in long-standing disease. The other ideas don’t fit this progression: glands aren’t consistently enlarged in chronic disease, nor consistently small from the start, and there is a recognizable pattern rather than no change.

In Addison disease, the adrenal glands reflect the disease stage. Early auto­immune inflammation can make the glands appear enlarged on imaging due to edema and lymphocytic infiltration. As the disease becomes chronic and the cortex is progressively destroyed, the glands undergo atrophy and shrink. So the typical pattern is enlarged in the acute/early phase, then small or atrophic in long-standing disease. The other ideas don’t fit this progression: glands aren’t consistently enlarged in chronic disease, nor consistently small from the start, and there is a recognizable pattern rather than no change.