All patients with Addison's disease require glucocorticoid replacement therapy, and the majority also need mineralocorticoid treatment. Hydrocortisone (cortisol) is now regarded as the drug of choice for glucocorticoid treatment since, unlike cortisone acetate, it does not need to be metabolised before it is metabolically active; it is also more readily absorbed, and 9a-fludrocortisone is used to treat the mineralocorticoid deficiency. Other autoimmune diseases may be present in patients with autoimmune adrenalitis and these should be treated if necessary.
