Necrosis of granule cells of hippocampus in adrenocortical failure.

A case of untreated and rapidly progressive Addison's disease in a 23-year old woman showed selective necrosis with karyorhexis of the granule cells in the hippocampus. We suggest that this unique lesion was caused by a severe adrenocortical insufficiency. This explanation is in accordance with a recent report of selective loss of hippocampal granule cells after complete adrenalectomy in rats. No evidence of nerve cell loss was found in three cases of Addison's disease that had received cortisone treatment, which is consistent with the experimental observation that even very low levels of cortisone in adrenalectomized rats are sufficient to prevent granule cell loss.