Addison's disease | |
---|---|
Other names | Addison disease, primary adrenal insufficiency,[1] primary adrenocortical insufficiency, chronic adrenal insufficiency, chronic adrenocortical insufficiency, primary hypocorticalism, primary hypocortisolism, primary hypoadrenocorticism, primary hypocorticism, primary hypoadrenalism |
![]() | |
Darkening of the skin seen on the legs of an otherwise fair-skinned patient | |
Specialty | Endocrinology |
Symptoms | Abdominal pain, weakness, weight loss, darkening of the skin[1] |
Complications | Adrenal crisis[1] |
Usual onset | Middle-aged females[1] |
Causes | Problems with the adrenal gland[1] |
Diagnostic method | Blood tests, urine tests, medical imaging[1] |
Treatment | Synthetic corticosteroid such as hydrocortisone and fludrocortisone[1][2] |
Frequency | 0.9–1.4 per 10,000 people (developed world)[1][3] |
Deaths | Doubles risk of death |
Named after | Thomas Addison |
Addison's disease, also known as primary adrenal insufficiency,[4] is a rare long-term endocrine disorder characterized by inadequate production of the steroid hormones cortisol and aldosterone by the two outer layers of the cells of the adrenal glands (adrenal cortex), causing adrenal insufficiency.[5][6] Symptoms generally come on slowly and insidiously and may include abdominal pain and gastrointestinal abnormalities, weakness, and weight loss.[1] Darkening of the skin in certain areas may also occur.[1] Under certain circumstances, an adrenal crisis may occur with low blood pressure, vomiting, lower back pain, and loss of consciousness.[1] Mood changes may also occur. Rapid onset of symptoms indicates acute adrenal failure, which is a clinical emergency.[5] An adrenal crisis can be triggered by stress, such as from an injury, surgery, or infection.[1]
Addison's disease arises when the adrenal gland does not produce sufficient amounts of the steroid hormones cortisol and (sometimes) aldosterone.[1] It is an autoimmune disease which affects some genetically predisposed people in whom the body's own immune system has started to target the adrenal glands.[7] In many adult cases it is unclear what has triggered the onset of this disease, though it sometimes follows tuberculosis.[7] Causes can include certain medications, sepsis, and bleeding into both adrenal glands.[1][8] Addison's disease is generally diagnosed by blood tests, urine tests, and medical imaging.[1]
Treatment involves replacing the absent or low hormones.[1] This involves taking a synthetic corticosteroid, such as hydrocortisone or fludrocortisone.[1][2] These medications are typically taken orally.[1] Lifelong, continuous steroid replacement therapy is required, with regular follow-up treatment and monitoring for other health problems which may occur.[9] A high-salt diet may also be useful in some people.[1] If symptoms worsen, an injection of corticosteroid is recommended (people need to carry a dose with them at all times).[1] Often, large amounts of intravenous fluids with the sugar dextrose are also required.[1] With appropriate treatment, the overall outcome is generally favorable,[10] and most people are able to lead a reasonably normal life.[11] Without treatment, an adrenal crisis can result in death.[1]
Addison's disease affects about 9 to 14 per 100,000 people in the developed world.[1][3] It occurs most frequently in middle-aged females.[1] The disease is named after Thomas Addison, a graduate of the University of Edinburgh Medical School, who first described the condition in 1855.[12][13]
NHS
was invoked but never defined (see the help page).© MMXXIII Rich X Search. We shall prevail. All rights reserved. Rich X Search