Home > Addison's disease
Addison's disease (also known as chronic adrenal insufficiency, or hypocortisolism) is a rare endocrine disorder. It is estimated that it affects about 1 to 5 in 100,000 people. It occurs when the adrenal glands, seated above the kidneys, fail to produce enough of the hormone cortisol and, sometimes, the hormone aldosterone. Addison's disease refers specifically to primary adrenal insufficiency, in which the adrenal glands themselves malfunction; secondary adrenal insufficiency occurs when the pituitary gland does not produce enough adrenocorticotropic hormone (ACTH) to adequately stimulate the adrenal glands. A famous sufferer of Addison's Disease was President John F. Kennedy.1 Signs and symptoms
1.1 Early signs
Addison's disease progresses slowly, and symptoms may not present or be noticed until some stressful illness or situation occurs. Common symptoms are:
- chronic fatigue that gradually worsens
- muscle weakness
- loss of appetite
- weight loss
- nausea/vomiting
- diarrhea
- low blood pressure that falls further when standing ( orthostatic hypotension)
- areas of hyperpigmentation (darkened skin)
- irritability
- depression
- craving for saltFor other meanings of the word salt see salt (disambiguation In chemistry, a salt is a composed of positively charged cations and negatively charged anions, so that the product is neutral and without a net charge. They are typically the product of a chemi and salty foods
- hypoglycaemia (worse in children)
- for women, menstrual periods that become irregular or cease
1.2 Addisonian crisis
An illness or accident can aggravate the adrenal problems and cause an Addisonian crisis in which the symptoms include:
- sudden penetrating pain in the legs, lower back or abdomen
- severe vomiting and diarrhea, resulting in dehydrationDehydration is the removal of water ( Greek hydros from an object. There are many methods of dehydration, with the most common being the application of dry heated air. This causes evaporation of the surface water, which is replaced by water internally.
- low blood pressure
- loss of consciousnessFor other meanings of the word "coma", especially in astronomy, see coma (disambiguation In medicine, a coma is a profound state of unconsciousness, which may result from a variety of conditions including intoxication ( drug, alcohol or toxins), metabolic
- hypoglycemiaHypoglycemia is a medical term referring to a pathologic state produced and usually defined by a lower than normal amount of sugar ( glucose) in the blood. The term hypoglycemia literally means low blood sugar. Hypoglycemia can produce a variety of sympto
Untreated, an Addisonian crisis can be fatal. It is a medical emergencyA medical emergency is an injury or illness that poses an immediate threat to a person's health or life which requires help from a doctor or hospital. The doctor's specialization of emergency medicine includes techniques for effective handling of medical.
2 Diagnosis
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. 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.
