Addison's Disease Flashcards
What is the aetiology of addison’s disease?
Autoimmune
Congenital adrenal hyperplasia with 21-Hydroxylase deficiency
What structure is damages in addisons disease?
The adrenal cortex
What enzyme is attacked in Addison’s disease?
21-Hydroxylase
What happens to the adrenal glands in addisons?
Adrenal hyperplasia
What infection can cause acute addisons?
Meningococcal septicaemia
What is the pathology of Addisons disease?
All steroid hormones lowered
- Especially cortisol
What are the symptoms of long term Addison’s disease?
Weakness
Fatigue
Weight loss
Depression
Psychosis
Salt craving
What are the symptoms of an addisonian crisis?
Hypotension
Vomiting + diarrhoea
Hypoglycaemia
Hyperpigmentation
- ACTH is melanocyte stimulating hormone
What immediate tests can be done to diagnose?
Random cortisol
Synacthen test
What random cortisol figure will indicate possible addisons i.e. uncertain adrenal status?
< 700nmol/l-1
What is the process of the synacthen test?
Take blood
- Assess cortisol and ACTH levels
Give 250micrograms tetracosactrin
- Essentially an ACTH analogue
Repeat bloods
Normal response = cortisol will increase
Addisons = no change
Treatment of addisons?
Replace glucocorticoid levels
Give
- Hydrocortisone
- Prednisolone
- Dexamethasone
Replace mineralcorticoids
- Fludrocortisone (maintains BP)
