Chronic adrenal insufficiency (Addison's disease) is extremely rare in the pediatric age group. In the approximately 100 such cases that have appeared in the literature to date, less than one fourth of the patients were children under 10 years of age.1 Adrenocortical tuberculosis was etiologically responsible for the majority of cases, whereas a smaller percentage was ascribed to bilateral adrenal cortex atrophy, agenesis or degeneration of unknown origin and hyperplasia of the adrenogenic zone of the cortex. Other etiologic factors responsible for the destruction of the adrenal cortex and the syndrome of Addison's disease in adults, namely, pyogenic abscesses, vascular lesions, mycosis fungoides, echinococcic cysts, amyloidosis, neoplasms, histoplasmosis, moniliasis and diphtheria, have not been demonstrated in children.2
Because of the relative rarity of Addison's disease in infancy and early childhood, the following case of the disease due to bilateral adrenal cortex atrophy in a 5½ year old boy