Addison's Disease

Question 1

What is Addison’s Disease?

Answer 1

Addison’s Disease is a condition in which there is hyposecretion from the adrenal cortex

Question 2

What hormone levels are affected by Addison’s Disease?

Answer 2

Hormones affected by Addison’s Disease include Cortisol Aldesterone Sex hormones

Question 3

What is the primary aetiology of Addison’s Disease?

Answer 3

Addison’s Disease is caused by autoimmune destruction of the adrenal cortex

Question 4

What are the eight symptoms of Addison’s Disease?

Answer 4

The symptoms of Addison’s Disease are Extreme fatigue Weight loss Anorexia Weakness Salt craving Nausea and Vomiting Diarrhoea Abdominal pain

Question 5

What are the five signs of Addison’s Disease?

Answer 5

Postural hypotension (decreased blood volume) Hypotension Hypoglycemia Vitiligo (pale patches on skin) Hyperpigmentation (generalised darkening of skin)

Question 6

What investigations would you use to investigate suspected Addison’s Disease?

Answer 6

To investigate suspected Addison’s Disease you would test

U & Es

Blood glucose

FBC

Random cortisol (If below 700 adrenal status unsure)

Question 7

What are the two diagnostic tests for Addison’s Disease?

Answer 7

The diagnostic tests for Addison’s Disease are

Short synachten test (and basal ACTH)

Plasma ACTH to determine primary or secondary cause

Question 8

What are the two treatments for Addison’s Disease?

Answer 8

Hydrocortisone 20 - 30mg/ day -

Sick day rule - if patient is unwell they must double dose (minor illness only, major illness will need further management)

Given in divided doses (morning and evening) to mimic normal variation

Fludrocortisone 50 - 300 micrograms/ day

Adjust dose according to clinical status (postural BP, oedema), U & Es and plasma renin.