As Thomas Addison observed in his famous monograph written in 1855, the adrenal glands are “objects of deep interest” and so they remain [1]. In the monograph he described several patients who presented with generalised weakness and in whom abnormalities of the adrenal glands were found atpost mortem. Addison had discovered primary hypoadrenalism, the disease that would later take his name. He observed that “the disease is by no means of very rare occurrence, and that were we better acquainted with its symptoms and progress, we should probably succeed in detecting many cases” [1].
With Addison's words ringing in our ears we reflect on the paper by Lapiet al.[2] in this issue of theEuropean Respiratory Journal. Lapiet al.[2] describe a nested case–control study examining the association between inhaled corticosteroids and adrenal insufficiency conducted within a cohort of patients treated for respiratory conditions over a 15-year period, starting in 1990, in Quebec, Canada. They identified 392 cases of adrenal insufficiency from 368 238 prevalent users of respiratory medicines from the Régie de l'assurance médicale du Québec database. They did not …