Addison's disease

Background

  • Primary adrenal insufficiency
  • Autoimmune disease (70-90%)
    • Tuberculosis previously most common cause
    • Other causes include infectious, metastatic cancer, lymphoma, adrenal hemorrhage, infarction, drugs
  • Typically presents in adults between 30 and 50 years of age
    • All ages, races, genders can be affected
  • Higher incidence with other autoimmune deficiencies

Clinical Features

  • Abdominal pain
  • Weakness and fatigue
  • Salt craving
  • Abnormal skin pigmentation - will often look patchy
  • Addisonian Crisis
    • Hypotension
    • Neurologic Symptoms: coma

Differential Diagnosis

  • Corticosteroid withdrawal
  • Secondary adrenal insufficiency - deficiency of ACTH (produced by the pituitary gland)
  • Tertiary adrenal insufficiency - deficiency of CRH (produced by the hypothalamus)

Evaluation

Laboratory findings

Evaluation

Management

Disposition

  • New Diagnosis: strong consideration for admission
  • Crisis?: Consider admission based on electrolytes and clinical presentation

See Also

External Links

References

  1. de Herder WW, van der Lely AJ (May 2003). "Addisonian crisis and relative adrenal failure". Reviews in Endocrine and Metabolic Disorders 4 (2): 143–7.