Definition

Addison's disease is a rare disorder of the adrenal glands. With Addison's, the adrenal glands do not produce enough of the hormones cortisol and aldosterone.

Adrenal Glands

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Addison's occurs because of damage to the cortex.
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Causes

Addison's disease is the result of gradual damage to the outer layer of the adrenal gland. This damage may be caused by:

  • An autoimmune reaction—the body's own immune system attacks the gland
  • Tuberculosis
  • Bleeding within the adrenal glands—related to the use of anticoagulant medications and shock
  • Surgical complication
  • Conditions that are present at birth or due to genetic factors such as enzyme defects and familial glucocorticoid insufficiency
  • Cytomegalovirus (CMV) infection associated with AIDS
  • Fungal infections
  • Certain cancers, including those that have spread
  • Certain medications
  • Radiation therapy
  • Chronic disorders, such as:

Risk Factors

Factors that may increase your chance Addison's disease include:

Symptoms

Symptoms may include:

  • Extreme weakness, fatigue
  • Weight loss
  • Nausea or vomiting
  • Chronic diarrhea
  • Muscle weakness or pain
  • Darkening of freckles, nipples, scars, skin creases, gums, mouth, nail beds, and vaginal lining
  • Emotional changes, especially depression
  • Cognitive impairment or confusion
  • Craving salty foods
  • Abdominal pain
  • Anorexia
  • Amenorrhea

A severe complication of Addison's disease is the Addisonian or adrenal crisis. Adrenal crisis is a life threatening disorder, its symptoms include:

  • High or low body temperature
  • Severe abdominal, back, or leg pain
  • Fainting
  • Severe dehydration
  • Severe nausea, vomiting, and diarrhea
  • Bluish skin color
  • Muscle weakness

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

  • Blood tests
  • Urine tests
  • ACTH stimulation test

Imaging tests evaluate the adrenal glands and surrounding structures. These may include:

Treatment

Symptoms of Addison's disease can be controlled with medications. They replace the missing hormones. Medication needs to be taken for the rest of your life. They may need to be increased during times of stress.

Immediate treatment of adrenal crisis includes:

  • Self-injection of dexamethasone
  • Hydrocortisone by IV
  • Normal saline by IV

Surgery may also be needed for adrenal tumors or pituitary tumors causing the disease.

Maintenance

Regular blood tests are needed to monitor your response to medication. Wear a medical alert bracelet that states adrenal insufficiency or Addison's disease. This will let others know of your condition if you are unable to communicate.

Prevention

There are no current guidelines to prevent Addison's disease. If you think you are at risk, talk to your doctor.