ADDISONS DISEASE - Watsons Health

ADDISONS DISEASE

A rare disorder in which there is a lack of steroid hormone production by the adrenal glands.

Usual causes are:

  • Damage caused by the body’s own immune system
  • Specific infections

Symptoms are nonspecific:

  • Pain in the abdomen
  • Weakness

May develop into Addisonian crisis, a severe condition manifesting as:

  • Very low blood pressure & coma – caused when the body is placed in a stressful situation i.e. accident, injury, surgery, severe infection or illness
  • Patient death may follow quickly

Other names: chronic adrenal insufficiency, hypocortisolism, and hypoadrenalism

Symptoms disease have a slow development and may become established before recognition.

Most common:

  • Fatigue; lightheadedness upon standing or difficulty standing;muscle weakness; fever; weight loss; anxiety; nausea; vomiting; diarrhea; headache; sweating; changes in mood or personality; and joint and muscle pains.

Other manifestations:

  • Salt or salty food craving casued by sodium loss through urination.
  • Hyperpigmentation of the skin, as well as darkening of the palmar crease, sites of friction, recent scars, vermilion border of the lips, and genital skin.

On Physical examination:

  • Low blood pressure with or without orthostatic hypotension (blood pressure that decreases with standing).

Associated with the development of other autoimmune diseases:

  • Type I diabetes, thyroid disease (Hashimoto’s thyroiditis), and vitiligo.
  • Presence of Addison’s in addition to any of the above conditions is called autoimmune polyendocrine syndrome.

DIAGNOSIS

  • Physician may do/request:
    • History & Physical Exam
    • Routine laboratory investigations may show:
      • Hypercalcemia
      • Hypoglycemia, low blood sugar (worse in children)
      • Hyponatremia (low blood sodium levels)
      • Hyperkalemia (raised blood potassium levels)
      • Eosinophilia and lymphocytosis (increased number of eosinophils or lymphocytes, two types of white blood cells)
      • Metabolic acidosis (increased blood acidity)

 

RECOMMENDED MEDICATION

  • Cortisol replacement (Usually lifelong treatment)
    • Hydrocortisone or Prednisone tablets
    • Prednisolone may also be used
    • Many patients may also require fludrocortisone

 

ADDITIONAL RECOMMENDATIONS

  • Carry information on one’s person (e.g. information card) for the use of emergency medical services personnel who might respond to their needs.
  • A needle, syringe, and injectable form of cortisol be carried for emergencies.
  • Increase one’s medication during these situations: illness, surgery or dental treatment.
  • Immediate medical attention is needed when severe infections, vomiting, or diarrhea occur, as these conditions can precipitate an Addisonian crisis.
    • If vomiting, patient may require injections of hydrocortisone instead.

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