Please enable JavaScript.
Coggle requires JavaScript to display documents.
Addison Disease - Coggle Diagram
Addison Disease
References
Cleveland Clinic. (2019, April 9).
Addison's disease
. Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/15095-addisons-disease
Huether, S.E., McCance, K.L., & Brashers, V.L. (2020).
Understanding pathophysiology
(7th ed.). Elsevier.
Mayo Clinic. (2019, Oct. 9).
Addison's disease
. Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293
National Health Service. (2018, June 14).
Addison's disease
. NHS.
https://www.nhs.uk/conditions/addisons-disease/
Tafuri, K. (2020, March 10).
Pediatric adrenal insufficiency (addison disease)
. Medscape.
https://emedicine.medscape.com/article/919077-overview
University of Rochester Medical Center. (2020).
Addison disease in children
. University of Rochester Medical Center.
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P01979
Cleveland Clinic. (2019, April 9).
Addison's disease: Management and treatment
. Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/15095-addisons-disease/management-and-treatment
Clinical Manifestations
Adult
and
pediatric
patients will feel extremely
lethargic
with Addison disease.
Adult
and
pediatric
patients may experience a
decreased appetite
and their weight might decrease.
Adult
and
pediatric
patients might have a
low blood pressure
and might feel faint.
Adult
and
pediatric
patients will experience
hyperpigmentation
of the skin and darkening of the skin.
Adult
and
pediatric
patients might become
hypoglycemic
.
Patients who are in an Addisonian crisis will experience
extreme weakness
,
hyponatremia
,
hyperkalemia
, and
confusion
.
Pediatric
Addison disease patients will often experience
black freckles
,
tachycardia
,
salt cravings
,
muscle weakness/aches
, and
darkening of the skin
to a blue/black color around the nipples, mouth, rectum, and vagina.
Treatments
Patients might take
hydrocortisone
,
prednisone
, or
methylprednisolone
on a 24-hour cycle to maintain hormone balance in the adrenal glands.
Patients might also take
fludrocortisone acetate
as a type of synthetic aldosterone to maintain the levels of that hormone in the body since the adrenal glands produce insufficient amounts in these patients.
Patients might carry a
glucocorticoid kit
with injectable steroids for emergency situations.
Glucocorticoid replacement therapy
is common for
all age groups
suffering from Addison Disease because this replaces the steroids that are not naturally being produced in this disease; thus, we are minimizing the symptoms using this treatment.
Adults
will receive
100mg
of
hydrocortisone
,
children
will receive
50 mg
of
hydrocortisone
, and
infants
will receive
25mg
of
hydrocortisone
to control Addison disease.
Adult
patients can increase their
sodium
intake to help counteract the effects of hyponatremia due to the lack of aldosterone being released.
Risk Factors
A patient is at a higher risk of developing Addison disease if they have a family history of
autoimmune diseases
, since idiopathic Addison disease is a genetic autoimmune disease.
Patients are also at a higher risk of developing Addison disease if they have had
tuberculosis
.
Patients are also at a higher risk of developing Addison disease if they have had
metastatic cancers
.
Patients are at a higher risk of developing Addison disease if they have had
amyloidosis
(a disorder in which protein builds up in the body and in the adrenal glands).
A patient is at a higher risk of developing Addison disease if they have had an
adrenalectomy
.
Pathogenesis
Addison disease can result from
primary adrenal insufficiency
, which results in trauma or damage to the adrenal glands.
The damage that occurs to the adrenal glands is most commonly caused by an
autoimmune disease
called
idiopathic Addison disease
, in which T-cells attack the body's adrenal cortex and cause the cells to atrophy.
When the adrenal glands are
damaged
, they are not able to efficiently produce
aldosterone
and
cortisol
. This results in the adrenal insufficiency that defines Addison disease.
Addison disease can also result from
secondary adrenal insufficiency
in which there is a tumor or damage to the
pituitary gland
that prevents the release of
adrenocorticotropic hormone
(ACTH) which is needed to stimulate the release of
cortisol
and
aldosterone
. When one does not have enough ACTH, there is little production of cortisol and aldosterone which results in Addison disease.
Diagnostics
A patient may receive a
blood test
to confirm Addison disease, as the adrenocorticotropic (ACTH) hormone, potassium, sodium, and cortisol levels are visible in the blood to determine the presence of an adrenal insufficiency. In
pediatric
patients, a blood cortisol level of 18 mcg/dL or less indicates an adrenal insufficiency.
A
pediatric
or
adult
patient may take an
ACTH simulation
test to see the amount of cortisol made by the adrenal glands in response to an injection of ACTH.
Pediatric
and
adult
patients might take an
insulin-tolerance test
where they will be given insulin, and the healthcare professionals will monitor their levels of cortisol and glucose in response to the insulin to look for signs of adrenal insufficiency. In healthy people, the glucose levels will decrease as cortisol levels increase.
Pediatric
and
adult
patients might also take imaging tests with a computerized tomography scanner to look for physical abnormalities in the adrenal glands.
Prevalence/Incidence
1 in every 100,000
adults
have Addison disease in the United States.
It will typically manifest in
both
men and women around ages 30-50.
Addison disease affects 1 out of every 16,000
infants
.
Both men and women have an
equal chance
of developing this disease.