AFIF BIN AIDIT082013100004

IMS BANGALORE

ADDISON’S DISEASE

LEARNING OUTCOMES

What is Addison’s diseasePathogenesisCausesClinical manifestationInvestigationsTreatments

DEFINITION

Body produces insufficient amount of cortisol or aldesterone

an autoimmune inflammation of adrenal gland

resulting in gradual destruction inability to make sufficient amounts of

adrenal hormones.FatalKnown as adrenal insufficiencyOccurs in all groups and both sexes

PATHOGENESIS

Occurs when more than 90% of adrenal gland tissue is destroyed

Primary Addison’s diseaseDue to autoimmune system, tuberculosis

CAUSES

PRIMARY SECONDARY1) Polyglandular syndrome2) Tuberculosis3) HIV/AIDS4) Metastatic carcinoma5) Bilateral adrenalectomy6) Amyloidosis7) Intra-adrenal haemorrhage

1) Withdrawal of suppressive glucocorticoid therapy

2) Hypothalamic or pituitary disease

CLINICAL MANIFESTATIONS

GLUCOCORTICOID INSUFFICINECY

MINERALCORTICOID INSUFFICIENCY

ACTH EXCESS ADRENAL ANDROGEN INSUFFICIENCY

1) Weight loss2) Malaise3) Weakness4) Diarrohea5) Postural

hypotension6) Hypoglycaem

ia7) Hyponatremi

a8) Hypercalcae

mia

1) Hypotension2) Hyponatremi

a3) Hyperkalemi

a

1) Pigmentation :

- palmar crease - knuckles - conjunctivae

1) Decreased body hair

2) Loss of libido, especially in female

INVESTIGATIONS

Random blood sample ( cortisol )ACTH stimulation testAssessment of mineralcorticoidsPlain x-rayUltrasoundHIV test

TREATMENTS

Glucocorticoid replacement therapyAdrenal androgen ( women )Mineralocorticoid replacement

REFERENCE

http://www.mayoclinic.org/diseases-conditions/addisons-disease/basics/definition/con-20021340

http://autoimmune.pathology.jhmi.edu/diseases.cfm?systemID=3&DiseaseID=16