Addison’s disease

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Addison's disease is a rare, chronic endocrine disorder in which the adrenal glands do not produce sufficient steroid hormones (glucocorticoids and often mineralocorticoids). It is characterized by a number of relatively nonspecific symptoms, such as abdominal pain and weakness, but under certain circumstances, these may progress to Addisonian crisis, a severe illness which may include very low blood pressure and coma. The disease is generally diagnosed by blood tests and medical imaging.

Causes[edit | edit source]

Addison's disease arises from problems with the adrenal gland itself, a state referred to as primary adrenal insufficiency, and can be caused by damage by the body's own immune system, certain infections, or various rarer causes. Addison's disease can also occur following surgical removal of the adrenal glands. It is named after Dr. Thomas Addison, a British physician who first described the condition in 1855.

Symptoms[edit | edit source]

The symptoms of Addison's disease develop slowly and may become serious before they are recognized. Symptoms include fatigue, muscle weakness, decreased appetite, and weight loss. Some people experience nausea, vomiting, and diarrhea. Other symptoms include pain in the muscles and joints, and some people have skin changes and areas of darkened (hyperpigmented) skin.

Diagnosis[edit | edit source]

The diagnosis of Addison's disease is made by laboratory tests. The aim of these tests is first to determine whether there are insufficient levels of cortisol and then to establish the cause. A short procedure called the ACTH (adrenocorticotropic hormone) stimulation test is often used to diagnose Addison's disease.

Treatment[edit | edit source]

Treatment for Addison's disease involves replacing the missing cortisol, sometimes in the form of hydrocortisone tablets, or prednisone tablets in a dosing regimen that mimics the physiological concentrations of cortisol. Alternatively, one-quarter as much prednisolone may be used for equal glucocorticoid effect as hydrocortisone. Treatment must usually be continued for life. In addition, many people require fludrocortisone as replacement for the missing aldosterone.

See also[edit | edit source]

Template:Adrenal gland diseases

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Contributors: Prab R. Tumpati, MD