Addison's Disease Flashcards
What is Addison’s Disease?
Primary adrenal insufficiency resulting in decreased production of adrenocortical hormones
What is secondary adrenal insufficiency?
Pituitary or hypothalamic involvement resulting in decreased ACTH secretion
What causes adrenal insufficiency in developed countries?
Autoimmune destruction
What enzyme is present in the majority of cases?
21-hydroxylase
What are risk factors?
Female, adrenocortical antibodies, other autoimmune diseases
What is a common cause of adrenal insufficiency in developing countries?
TB
What are symptoms of adrenal insufficiency?
Fatigue, weakness, weight loss. nausea/vomiting, abdominal pain, diarrhoea/constipation
What are signs of adrenal insufficiency?
Hyperpigmentation in Addison’s, postural hypotension, hypoglycaemia
What will sodium and potassium levels be?
Sodium decreased, potassium increased
What would you see on an FBC?
Anaemia, eosinophilia
What would morning serum cortisol be?
Reduced
What imaging would you do?
Adrenal CT or MRI
How do you treat adrenal insufficiency?
Glucocorticoid + mineralocorticoid, treat underlying state
What hormones are decreased in Addison’s?
Cortisol and aldosterone
What is a common cause of secondary adrenal insufficiency?
Iatrogenic - long term steroid therapy
