Addison's syndrome

Addison's disease (also known as primary adrenal insufficiency and hypocortisolism) is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Symptoms generally come on slowly and may include abdominal pain, weakness, and weight loss. Darkening of the skin in certain areas may also occur. Under certain circumstances, an adrenal crisis may occur with low blood pressure, vomiting, lower back pain, and loss of consciousness. An adrenal crisis can be triggered by stress, such as from an injury, surgery, or infection.

Causes

Addison's disease arises from problems with the adrenal gland itself, leading to a low production of the hormone cortisol and often aldosterone as well. A common cause is when the immune system mistakenly attacks the adrenal glands, a process known as autoimmune Addison's disease. Other causes include certain infections, such as tuberculosis, HIV/AIDS, and fungal infections, cancers that spread to the adrenal glands, certain genetic conditions, and removal of the adrenal glands.

Diagnosis

Diagnosis of Addison's disease is made through blood tests, and sometimes imaging tests such as a CT scan. Blood tests may show low levels of cortisol and aldosterone, but high levels of ACTH, a hormone that stimulates the adrenal glands. A CT scan may show changes in the size and shape of the adrenal glands.

Treatment

Treatment for Addison's disease involves replacing the missing cortisol, often in the form of hydrocortisone tablets, and if necessary, fludrocortisone to replace aldosterone. In addition, people with Addison's disease are often advised to increase their intake of salt, especially during periods of heavy exercise or in hot weather.

Prognosis

With proper treatment, most people with Addison's disease can lead normal lives. However, they must be constantly aware of the risk of an adrenal crisis, which is a medical emergency.

See also

• Adrenal gland
• Adrenal insufficiency
• Autoimmune disease
• Cortisol
• Aldosterone

Addison's syndrome Resources
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