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