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Understanding Addison's Disease Overview

Addison's disease, also known as primary adrenal insufficiency, is caused by insufficient production of cortisol and aldosterone by the adrenal cortex. It can be primary, resulting from damage to the adrenal glands, or secondary from exogenous steroid use suppressing ACTH. Symptoms include weakness, weight loss, low blood pressure, and hyperpigmentation. It is diagnosed through blood tests showing low cortisol and aldosterone levels and high renin that do not respond to ACTH stimulation. Treatment involves glucocorticoid and mineralocorticoid hormone replacement, especially hydrocortisone, to manage symptoms and prevent adrenal crisis.

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115 views12 pages

Understanding Addison's Disease Overview

Addison's disease, also known as primary adrenal insufficiency, is caused by insufficient production of cortisol and aldosterone by the adrenal cortex. It can be primary, resulting from damage to the adrenal glands, or secondary from exogenous steroid use suppressing ACTH. Symptoms include weakness, weight loss, low blood pressure, and hyperpigmentation. It is diagnosed through blood tests showing low cortisol and aldosterone levels and high renin that do not respond to ACTH stimulation. Treatment involves glucocorticoid and mineralocorticoid hormone replacement, especially hydrocortisone, to manage symptoms and prevent adrenal crisis.

Uploaded by

Christian Martinez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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ADDISON´S

DISEASE

ROJAS MARTINEZ CHRISTIAN DE JESUS. 8 B


DRA. SALCEDO OROZCO THANIA.
DEFINITION

• Addison’s disease, the traditional term for primary adrenal


insufficiency, is defined as the clinical manifestation of chronic
glucocorticoid- and/or mineralocorticoid deficiency due to failure of
the adrenal cortex which may result in an adrenal crisis with
potentially life-threatening consequences.
ETIOLOGY AND CLASSIFICATION

• This is caused by an inability of the adrenal cortices to produce adequate


adrenocortical hormones. Adrenal insufficiency is classified as primary or
secondary.
• Primary Adrenal Insufficiency
• Any disease process which causes direct injury to the adrenal cortex can
result in primary adrenal insufficiency (Addison disease).
• Secondary Adrenal Insufficiency
• Secondary insufficiency occurs most commonly due to exogenous steroid
administration resulting in the suppression of ACTH synthesis.

• Primary = autoimmune-mediated intrinsic adrenal gland dysfunction


(both cortisol and aldosterone deficiency).
• Secondary = chronic glucocorticoid administration resulting in hypothalamic-
pituitary dysfunction (only cortisol deficiency).
EPIDEMIOLOGY

• Addison disease is rare. The incidence is 0.6 per 100,000 of the


population per year.
• The total number of people affected by this condition at a
given time ranges from 4 to 11 per 100,000 of the population. In
adults, the common age of presentation is 30 to 50 years.
PATHOPHYSIOLOGY

• Adrenal failure in Addison disease results in decreased cortisol


production initially followed by that of aldosterone, both of which will
eventually result in an elevation of adrenocorticotropic (ACTH)
and melanocyte-stimulating hormone (MSH) hormones due to the
loss of negative feedback inhibition
MANIFESTATIONS

• The dramatic consequences of adrenal failure with weakness,


weight loss, anorexia, orthostatic hypotension due to
dehydration, salt craving, hyperpigmentation, musculoskeletal
and abdominal pain, nausea, and vomiting.
DIAGNOSIS

• The diagnosis is established by demonstrating low cortisol and aldosterone levels,


high renin level, and a blunt cortisol response with ACTH stimulation. The approach
for the evaluation s as follows;
• An inappropriately low cortisol level.
• Assessing the adrenal cortex's functional capacity to synthesize cortisol and
determine whether the cortisol deficiency is related to a corticotropin (ACTH)
deficiency.
• Determining whether a treatable cause is present.
TREATMENT

• Early recognition is critical for the management of adrenal insufficiency.


• Acute Phase
• Patients with an adrenal crisis require the following:
• Fluid resuscitation to restore the intravascular volume with intravenous (IV) normal saline
• Dextrose to correct hypoglycemia
• Correction of the hormone deficiency, both glucocorticoid and mineralocorticoid

• The immediate hormonal treatment is the administration of hydrocortisone.


REFERENCES

• Munir, S., Quintanilla Rodriguez, B. S., & Waseem, M. (2021). Addison Disease. In StatPearls. StatPearls
Publishing.
• Barthel, A., Benker, G., Berens, K., Diederich, S., Manfras, B., Gruber, M., Kanczkowski, W., Kline, G.,
Kamvissi-Lorenz, V., Hahner, S., Beuschlein, F., Brennand, A., Boehm, B. O., Torpy, D. J., & Bornstein, S. R.
(2019). An Update on Addison's Disease. Experimental and clinical endocrinology & diabetes : official journal,
German Society of Endocrinology [and] German Diabetes Association, 127(2-03), 165–175.
[Link]
• Pearce, S., Gan, E. H., & Napier, C. (2021). MANAGEMENT OF ENDOCRINE DISEASE: Residual adrenal
function in Addison's disease. European journal of endocrinology, 184(2), R61–R67.
[Link]

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