Adisson's Disease

Question 1

Definition of Addison’s disease

Answer 1

Addison’s disease is a condition in which the adrenal glands do not produce sufficient amounts of cortisol and sometimes aldosterone. It is primarily caused by autoimmune destruction of the adrenal cortex, but other causes include infections, certain medications, or damage to the adrenal glands.

Question 2

Diagnosis of Addison’s disease

Answer 2

Blood tests: Measurement of cortisol, adrenocorticotropic hormone (ACTH), and electrolyte levels, such as sodium and potassium, can help assess adrenal function.

ACTH stimulation test: This test involves measuring cortisol levels before and after synthetic ACTH is administered. In Addison’s disease, cortisol levels do not adequately increase in response to ACTH.

Imaging tests: Imaging techniques, such as CT or MRI scans, may be performed to evaluate the adrenal glands for structural abnormalities.

Question 3

Symptoms of Addison’s disease

Answer 3

Fatigue and weakness
Weight loss and decreased appetite
Hyperpigmentation (darkening) of the skin, particularly in sun-exposed areas and skin folds
Low blood pressure and dizziness upon standing
Salt cravings and low blood sugar (hypoglycemia)
Nausea, vomiting, and abdominal pain
Muscle or joint pain
Depression or irritability
Loss of body hair
Menstrual irregularities in women
Symptoms can worsen during times of physical stress, such as illness, injury, or surgery, and may progress to a life-threatening adrenal crisis if left untreated.

Question 4

Complications of Addison’s disease

Answer 4

Adrenal crisis: An adrenal crisis is a life-threatening emergency characterized by a sudden and severe worsening of symptoms, such as low blood pressure, dehydration, electrolyte imbalances, and shock. It requires immediate medical attention.

Addisonian crisis: This refers to the acute exacerbation of Addison’s disease, often triggered by infection, surgery, trauma, or stress. It can result in cardiovascular collapse and requires emergency treatment.

Question 5

Treatment of Addison’s disease

Answer 5

Glucocorticoid replacement: Oral corticosteroids, such as hydrocortisone or prednisone, are taken daily to replace cortisol.

Mineralocorticoid replacement: In some cases, oral fludrocortisone is prescribed to replace aldosterone and maintain electrolyte balance.

Individualized dosing adjustments: Dosages of hormone replacement therapy may need to be adjusted based on factors like stress, illness, or physical activity.

Adrenal crisis management: Education and emergency plans are essential to manage adrenal crises promptly with intravenous glucocorticoids, fluids, and electrolyte replacement.