Addison's Flashcards
what is addisons disease and who does it affect
characterised by glucocorticoid, mineral corticoid and sex steroid production are all reduced. reduced cortisol levels lead, through feedback, to increased CRH and ATCH production, the latter being responsible for hyperpigmentation.
- female predominance
- rare (incidence of 3-4/million a year)
- most common in ages 30 - 50
what are the causes of addison’s
Adrenal failure in Addison disease results in decreased cortisol production initially followed by that of aldosterone, both of which will eventually result in an elevation of adrenocorticotropic (ACTH) and melanocyte-stimulating hormone (MSH) hormones due to the loss of negative feedback inhibition.
primary adrenal insufficiency - auto immune disease of the outer layer of the adrenal gland (cortex)
- TB
- infection of adrenal gland
- cancer
- bleeding into the adrenal glands
secondary - pituitary disorders of ACTH production. too little means little glucocorticoids and androgens. tumours, inflammation and pituitary surgery
clinical presentation of Addisons disease
The initial presentation includes fatigue, generalized weakness, weight loss, nausea, vomiting, abdominal pain, dizziness, tachycardia, and/or postural hypotension.
Hyperpigmentation is characteristic and occurs in almost all patients. It is usually generalized and most prominent in sun-exposed and pressure areas. Elevated ACTH and melanocyte-stimulating hormone are causative factors. It is believed that ACTH binds to the melanocyte receptors
what are the risk factors of addisons
Risk factors for the autoimmune (most common) type of Addison’s disease include other autoimmune diseases:
Type I diabetes
Hypoparathyroidism
Hypopituitarism
Pernicious anemia
Graves’ disease
Family history of autoimmune disorders and tuberculosis.
addisons treatment
- lifelong hormonal replacement therapy, typically with oral corticosteroids and aldosterone
- may require increased salt intake and adjustments to medication during illness or stress.
