- Addison's disease is caused by the destruction of the central part of the adrenal glands. This area makes the following hormones: Cortisol (which responds to stress and affects the immune system, inflammation, and blood sugar), aldosterone (regulates kidneys and blood pressure), and androgens (sex hormones though not their primary source).
- Weight loss
- Muscle aches
- Joint aches
- Loss of appetite
- Emotional lability
- Chronic Diarrhea
- Salt craving
- Autoimmune destruction is the most common cause
-- i.e., the body's immune system mistakenly
attacks the adrenal glands.
bacterium may infect the gland (now a rare cause in the
- Hemorrhage (bleeding) into the
adrenal glands generally occurs in patients on
anticoagulants (blood thinners) during open-heart surgery
and after trauma.
- Many other disorders, such as Metastatic Cancer (lung, breast, kidney, or colon), side effects of drugs (e.g., Ketoconazole), radiation therapy, surgical removal of adrenals, Sarcoidosis, Amyloidosis, and infections (e.g., Histoplasmosis,
meningococcemia, etc.) may very rarely cause Addison's
- Findings that may present on examination:
- Low Blood Pressure
- Increased heart rate
- Dilated pupils
- Confusion or memory problems
- Mouth -- may have pigmented areas
inside the cheeks
- Skin becomes darker (''appears
- Multiple new freckles
- Darkening of the skin of the
elbows, knuckles, and knees.
- Darkening of the skin of the back
of the neck, palm creases, and nail beds.
- Nipples and areolas (pigmented areas
of the breast) become darker
- Vitiligo (areas of
skin lose all color)
- White blood cell proportions in
blood are altered
- Blood sugar is often low
- Sodium level is low
- Potassium level is
- Calcium level may
- High levels of very long chain
fatty acids (VLCFAs)
- Low morning plasma Cortisol
- ACTH level is elevated
- Cosyntropin stimulation test
- Anti-adrenal antibodies
- Chest X-Ray to look for cancer, Tuberculosis,
- Abdominal X-Ray may show calcification (Calcium deposits)
in the adrenals.
- CT scan of abdomen to evaluate the adrenal
- Replacement therapy for hormones no
longer being manufactured by the adrenal gland
- Hydrocortisone or
- Fludrocortisone acetate
- Extra salt (NaCl) in diet
- Appropriate amounts of Potassium and water
in the diet.
- The dose of Hydrocortisone or
Prednisone must be increased when the body is under stress, such as with an infection or around the time of surgery. This is very important and can be life threatening if not properly monitored by a physician.
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