Addison’s disease is also known as chronic adrenal insufficiency or hypocortisolism or hypocorticism is a rare endocrine disorder wherein the adrenal glands produce insufficient steroid hormones.
Addison’s disease is an endocrine or hormonal disorder that occurs in all age groups and afflicts men and women equally.
The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and nonexposed parts of the body.
Addison’s disease occurs when the adrenal glands do not produce enough of the hormone cortisol and in some cases, the hormone aldosterone.
Cortisol is normally produced by the adrenal glands, located just above the kidneys.
1.Helps maintain blood pressure and heart function.
2.Helps slow the immune system’s inflammation response.
3.Helps balance the effects of insulin in breaking down sugar for energy.
4.Helps regulate the metabolism of proteins, carbohydrates, and fats.
5.Helps maintain proper arousal and sense of well-being.
Aldosterone belongs to a class of hormones called mineralocorticoids, also produced by the adrenal glands.
It helps in maintaining blood pressure and water and salt balance in the body.
1.Primary adrenal insufficiency-Failure to produce adequate levels of cortisol due to disorder of the adrenal glands themselves.
a.Tuberculosis (TB), an infection which can destroy the adrenal glands.
Less common causes of primary adrenal insufficiency are:
b.chronic infection, mainly fungal infections
c.cancer cells spreading from other parts of the body to the adrenal glands
d.surgical removal of the adrenal glands
2.Secondary adrenal insufficiency- Failure to produce adequate levels of cortisol due to inadequate secretion of ACTH by the pituitary gland.
This form of adrenal insufficiency is much more common than primary adrenal insufficiency.
Less commonly, adrenal insufficiency occurs when the pituitary gland either decreases in size or stops producing ACTH.
These events can result from:
a.tumors or infections of the area
b.loss of blood flow to the pituitary
c.radiation for the treatment of pituitary tumors
d.surgical removal of parts of the hypothalamus
e.surgical removal of the pituitary gland
1.chronic, worsening fatigue
3.loss of appetite
8.low blood pressure causing dizziness or fainting
9.skin changes are hyperpigmentation covering exposed and nonexposed parts of the body
10. irritability and depression
A review of a patient’s medical history based on the symptoms.
a.ACTH Stimulation Test
This is the most specific test for diagnosing Addison’s disease.
d.tuberculin skin test
a.Treatment of Addison’s disease involves replacing or substituting the hormones which are not produced by the adrenal glands.
b.If cortisol is deficient, it is replaced orally with hydrocortisone tablets, a synthetic glucocorticoid.
c.If aldosterone is deficient, it is replaced with oral doses of a mineralocorticoid called fludrocortisone acetate.
d.Patients receiving aldosterone replacement therapy are usually advised by a doctor to increase their salt intake.
Patients with chronic adrenal insufficiency need surgery.
Given to the patient with:
a. nerve depression
d.feeble heart action
e.tendency to vomit
f.both the burning and the discoloration of the skin
Given in cases of:
a.brown spots upon the back of the hands
b.excessive mental and physical prostration
c.trembling of legs
e.want of appetite,
f.nausea and vomiting
g.depression of mind with irritability