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Page: Diagnosis
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In suspected cases of Addison's disease, one needs to demonstrate that adrenal hormone levels are low after appropriate stimulation with synthetic pituitary hormone.
Once demonstrated, the cause of adrenal failure needs to be elucidated. Today, the most common cause is autoimmune, and can be tested for with an assay for 21-hydroxylase antibodies. If there are no antibodies present, infectious or genetic causes should be sought. This may include imaging of the adrenal glands, tests for tuberculosis or HIV infection, and searching for metastatic cancer. When Dr. Addison discovered the disease in the 19th century, the most common cause was tuberculosis, and more widespread.
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