Addison's Disease
Pathogenesis
It can be characterized by inadequate corticosteroid and mineralocorticoid synthesis and elevated levels of serum ACTH
Caused by autoimmune mechanisms that destroy adrenal cortical cells
Incidence/Prevalence
Approximately 1 in 100,000 people in United States have Addison’s disease. The overall prevalence is estimated to be between 40 and 60 people per million of the general population
The incidence is 0.6/100,000 of the population per year
The total number of people affected by this condition at a given time 4 to 11/100,000 of the population
Risk Factors
Swelling (inflammation) of the thyroid gland that often results in reduced thyroid function
Thyroid gland produces too much thyroid hormone
Itchy rash with bumps and blisters
Parathyroid glands in the neck do not produce enough parathyroid hormone
Pituitary gland does not produce normal amounts of some or all of its hormones
Autoimmune disorder that affects the nerves and the muscles they control
Body does not have enough healthy red blood cells
Testicles cannot produce sperm or male hormones
Type I diabetes
Loss of brown color (pigment) from areas of the skin
Diagnostics
Blood test: Measures your blood levels of sodium, potassium, cortisol and adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce its hormones
ACTH stimulation test: This test measures the level of cortisol in your blood before and after an injection of synthetic ACTH
Insulin-induced hypoglycemia test: The test involves checking your blood sugar (blood glucose) and cortisol levels after an injection of insulin
Imaging tests: Computerized tomography (CT) scan of your abdomen to check the size of your adrenal glands and look for other abnormalities
Treatments
All treatment for Addison's disease involves medication
Hydrocortisone (Cortef), prednisone or methylprednisolone to replace cortisol
Fludrocortisone acetate to replace aldosterone
You will need to get plenty of salt (sodium) in your diet
Clinical Manifestations
Extreme fatigue
Weight loss and decreased appetite
Darkening of your skin (hyperpigmentation)
Low blood pressure, even fainting
Salt craving
Low blood sugar (hypoglycemia)
Nausea, diarrhea or vomiting (gastrointestinal symptoms)
Abdominal pain
Muscle or joint pains
Irritability
Depression or other behavioral symptoms
Body hair loss or sexual dysfunction in women
Women are more likely than men to develop Addison’s disease.
This condition occurs most often in people between the ages of 30 and 50
Sources
Huether, S. E., McCance, K. L., & Brashers, V. L. (2020). Understanding pathophysiology. St. Louis, MO: Elsevier.
Addison’s Disease. (2018, January 17). Retrieved September 30, 2020, from https://rarediseases.org/rare-diseases/addisons-disease/
Munir, S., & Waseem, M. (2020, July 05). Addison Disease. Retrieved September 30, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK441994/
Addison disease: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved September 30, 2020, from https://medlineplus.gov/ency/article/000378.htm
Mayo Clinic. (2019, October 09). Addison's disease. Retrieved October 13, 2020, from https://www.mayoclinic.org/diseases-conditions/addisons-disease/diagnosis-treatment/drc-20350296