Addison's Disease

Question 1

What are the main symptoms/signs of Addison’s disease? How do they occur?

Answer 1

• Hyperpigmentation (ACTH overproduction)
• Hypotension (aldosterone underproduction)
• Fatigue, anorexia, weight loss

Question 2

What are the main investigative findings in someone with Addison’s disease?

Answer 2

• FBE - may show anaemia
• UEC - low Na, high K
• Low serum cortisol and negative synacthen test

Question 3

How might you manage someone with Addison’s disease?

Answer 3

• Adrenal crisis
  
  • IV dexamethasone, fluid replacement
• Ongoing management
  
  • Oral hydrocortisone and fludrocortisone
  • Increase hydrocortisone if under stress (surgery etc.)