Addison's Disease Flashcards
what is addison’s disease?
autoimmune destruction of the adrenal glands leading to hypoadrenalism
what does addison’s disease cause?
hypoadrenalism
* reduced cortisol
* reduced aldosterone
what are the non-specific features of addison’s disease?
- lethargy
- weakness
- anorexia
- nausea and vomiting
- weight loss
- ‘salt-craving’
what are the features of addison’s disease?
- generally unwell
- hyperpigmentation
- vitiligo
- loss of pubic hair in women
- hypotension
- hypoglycaemia
what is the classical pattern of hyperpigmentation in addison’s disease?
palmar creases
what electrolyte imbalances are seen in addison’s disease?
- hyponatraemia (low Na)
- hypoglycaemia (low glucose)
- hyperkalaemia (high K)
what are the signs of addisonal crisis?
- collapse
- shock
- pyrexia
what feature differentiates addison’s disease from secondary causes of hypoadrenalism?
hyperpigmentation
what kind of acid-base disturbance is seen in addison’s disease?
metabolic acidosis
what is the definitive investigation in addison’s disease?
ACTH stimulation test
(short synacthen test)
what autoantibodies can be seen in addisons?
anti-21-hydroxylase
what is the alternative test that can be done in primary care for suspected addisons disease?
9am serum cortisol
9am serum cortisol of >500 nmol/l
addisons very unlikely
9am serum cortisol of < 100 nmol/l
abnormal
9am serum cortisol of 100-500 nmol/l
ACTH stimulation test
