Addison Disease :-
Addison disease is a disorder that take place when the adrenal glands do not generate sufficient hormones.
Addison Disease Causes :-
The adrenal glands are small hormone-releasing organs situated on top of each kidney. They are made up of an outer portion, known as the cortex, and an inner portion, known as the medulla.
( A ) The cortex generate 3 hormones :
• Glucocorticoid hormones (such as cortisol) maintain sugar (glucose) control, lower (suppress) immune response, and help the body respond to stress.
• Mineralocorticoid hormones (such as aldosterone) control sodium, water and potassium balance.
• Sex hormones, like androgens in male and estrogens in female, affect sexual development and sex drive.
Addison disease outcome from damage to the adrenal cortex. The damage give rise to the cortex to generate hormone levels that are very low.
( B ) This injury can be caused by the following :
• The immune system wrongly attacking the adrenal glands (autoimmune disease)
• Infections like tuberculosis, HIV, or fungal infections
• Hemorrhage into the adrenal glands
• Tumors
( C ) Risk factors for the autoimmune type of Addison disease involve other autoimmune diseases :
• Inflammation of the thyroid gland that frequently results in lower thyroid function (chronic thyroiditis)
• Thyroid gland generates too much thyroid hormone (overactive thyroid, Graves disease)
• Itching rashes with bumps and blisters (dermatitis herpetiformis)
• Parathyroid glands in the neck do not generate sufficient parathyroid hormone (hypoparathyroidism)
• Pituitary gland does not generate normal amounts of some or all of its hormones (hypopituitarism)
• Autoimmune disorder that affects the nerves and the muscles they manage (myasthenia gravis)
• Body does not have sufficient healthy red blood cells (pernicious anemia)
• Testicles cannot generate sperm or male hormones (testicular failure)
• Type I diabetes
• Lossing of brown color (pigment) from areas of the skin (vitiligo).
Specific rare genetic defects can also give rise to adrenal insufficiency.
Addison Disease Symptoms :-
Symptoms of Addison disease can involve any of the following :
• Abdominal pain,
• Chronic diarrhea, nausea, and vomiting,
• Darkening of the skin,
• Dehydration,
• Dizziness while standing up,
• Low-grade fever,
• Low blood sugar,
• Low blood pressure,
• Extreme weakness, fatigue, and slow, sluggish movement,
• Skin darkening on the inside of the cheeks and lips (buccal mucosa)
• Salt craving (eating food with a lot of added salt)
• Weight loss with lowered appetite.
Symptoms can not be present all the time. Many people have some or all of these symptoms when they have an infection or other stress on the body. Other times, they may not have any symptoms.
Addison Disease Test :-
Your health care team will do a physical exam and ask about the symptoms.
( A ) Blood tests will probably be ordered and can show :
• Increased potassium,
• Low blood pressure, mostly with a change in body position,
• Low cortisol level,
• Low sodium level,
• Low pH,
• Normal testosterone and estrogen levels, but low DHEA level,
• High eosinophil count.
Additional laboratory tests can be told to do.
( B ) Other tests may include:
• Abdominal x-ray,
• Abdominal CT scan,
• Cosyntropin (ACTH), stimulation test.
Addison Disease Treatment :-
Treatment with replacement corticosteroids and mineralocorticoids will manage the symptoms of this disease. These medicines commonly need to be taken for life.
Never skip doses of your medicine for this condition because life-threatening reactions can take place.
Your health care team can tell you to increase your dosage for a short time because of :
• Infection,
• Injury,
• Stress,
• Surgery.
During an very form of adrenal insufficiency, known as adrenal crisis, you must inject hydrocortisone right away. Treatment for low blood pressure is commonly required as well.
Some people with Addison disease (or family members) are taught to give themselves an urgent injection of hydrocortisone during stressful situations. Always take medical ID (card, bracelet, or necklace) that says you have adrenal insufficiency. The ID should also say the type of medicine and dosage you required in case of an emergency.