Addison’s Disease

An endocrine disorder characterized by insufficient production of steroid hormones by the adrenal glands

Addison's disease
Location of the adrenal glands
Synonyms	Primary adrenal insufficiency, hypocortisolism
Pronounce	N/A
Specialty	N/A
Symptoms	Fatigue, muscle weakness, weight loss, low blood pressure, darkening of the skin
Complications	Adrenal crisis
Onset	Any age
Duration	Long term
Types	N/A
Causes	Autoimmune destruction of the adrenal cortex, infections, genetic factors
Risks	N/A
Diagnosis	Blood tests, ACTH stimulation test, imaging
Differential diagnosis	N/A
Prevention	N/A
Treatment	Hormone replacement therapy
Medication	N/A
Prognosis	N/A
Frequency	4.4–11 per 100,000 people
Deaths	N/A

Addison's disease, also known as primary adrenal insufficiency or hypocortisolism, is a rare endocrine disorder in which the adrenal glands do not produce sufficient steroid hormones, primarily cortisol and, in some cases, aldosterone. The condition is named after Thomas Addison, the British physician who first described it in 1855.

Signs and symptoms

The symptoms of Addison's disease develop gradually and can be quite varied. Common symptoms include:

• Chronic fatigue and muscle weakness
• Loss of appetite and weight loss
• Low blood pressure, which may cause dizziness or fainting
• Hyperpigmentation, or darkening of the skin, particularly in areas exposed to the sun and at pressure points
• Salt craving due to low aldosterone levels
• Nausea, vomiting, and diarrhea
• Abdominal pain
• Joint and muscle pain

In some cases, an acute adrenal crisis may occur, characterized by severe pain, vomiting, diarrhea, dehydration, and loss of consciousness. This is a medical emergency and requires immediate treatment.

Causes

The most common cause of Addison's disease is an autoimmune response, where the body's immune system attacks the adrenal cortex. Other causes include:

• Tuberculosis and other infections that can damage the adrenal glands
• Genetic defects affecting adrenal gland development or function
• Metastatic cancer
• Hemorrhage into the adrenal glands

Diagnosis

Diagnosis of Addison's disease involves a combination of clinical evaluation and laboratory tests. Key diagnostic tests include:

• Blood tests to measure levels of sodium, potassium, cortisol, and adrenocorticotropic hormone (ACTH)
• ACTH stimulation test to assess adrenal gland function
• Imaging studies, such as CT or MRI, to evaluate the size and structure of the adrenal glands

Treatment

The primary treatment for Addison's disease is hormone replacement therapy to correct the deficiency of cortisol and aldosterone. This typically involves:

• Oral corticosteroids, such as hydrocortisone, prednisone, or dexamethasone
• Mineralocorticoid replacement with fludrocortisone to maintain sodium and potassium balance

Patients are advised to carry a medical alert card or wear a bracelet indicating their condition, as they may require emergency treatment during an adrenal crisis.

Prognosis

With appropriate treatment, individuals with Addison's disease can lead normal lives. However, they must be vigilant about managing their condition, particularly during times of stress or illness, which may require adjustments in medication.

Also see

• Adrenal gland
• Cortisol
• Endocrinology
• Autoimmune disease
• Adrenal crisis