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Addison's Disease

(Adrenal Insufficiency; Adrenocortical Hypofunction; Chronic Adrenocortical Insufficiency; Hypoadrenalism)

Definition

Addison's disease is a rare disorder of the adrenal glands. With Addison's, the adrenal glands do not produce enough of the hormones cortisol and aldosterone.
Adrenal Glands
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Addison's occurs because of damage to the cortex.
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Causes

Addison's disease is the result of gradual damage to the outer layer of the adrenal gland. This damage may be caused by:

Risk Factors

Factors that may increase your chance Addison's disease include:

Symptoms

Symptoms may include:
A severe complication of Addison's disease is the Addisonian or adrenal crisis . Adrenal crisis is a life threatening disorder, its symptoms include:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
Imaging tests evaluate the adrenal glands and surrounding structures. These may include:

Treatment

Symptoms of Addison's disease can be controlled with medications. They replace the missing hormones. Medication needs to be taken for the rest of your life. They may need to be increased during times of stress.
Immediate treatment of adrenal crisis includes:
Surgery may also be needed for adrenal tumors or pituitary tumors causing the disease.

Maintenance

Regular blood tests are needed to monitor your response to medication. Wear a medical alert bracelet that states adrenal insufficiency or Addison's disease. This will let others know of your condition if you are unable to communicate.

Prevention

There are no current guidelines to prevent Addison's disease. If you think you are at risk, talk to your doctor.

RESOURCES

Family Doctor (American Academy of Family Physicians) http://familydoctor.org

National Adrenal Diseases Foundation http://www.nadf.us

CANADIAN RESOURCES

The Canadian Addison Society http://www.addisonsociety.ca

Health Canada http://www.hc-sc.gc.ca

References

Adrenal insufficiency and Addison's disease. National Endocrine and Metabolic Diseases Information Service website. Available at: http://endocrine.niddk.nih.gov/pubs/addison/addison.aspx. Updated May 14, 2014. Accessed June 4, 2014.

Adrenal insufficiency in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 16, 2013. Accessed June 4, 2014.

Arlt W, Allolio B. Adrenal insufficiency. Lancet. 2003;361(9372):1881-1893.

Dorin RI, Qualls CR, Crapo LM. Diagnosis of adrenal insufficiency. Ann Int Med. 2003;138(3):194-214.

Hahner S, Allolio B. Therapeutic management of adrenal insufficiency. Best Pract Res Clin Endocrinol Metab. 2009;23(2):167-179.

Salvatori R. Adrenal insufficiency. JAMA. 2005;294(19):2481-2488.

Ten S, New M, Maclaren N. Clinical Review 130: Addison's disease. J Clin Endo Metabol. 2001;86(7):2909-2922.

Thomas Z, Fraser GL. An update on the diagnosis of adrenal insufficiency and the use of corticotherapy in critical illness. Ann Pharmather. 2007;419(9):1456-65.

Wallace I, Cunningham S, Lindsay J. The diagnosis and investigation of adrenal insufficiency in adults. Ann Clin Biochem. 2009;46(Pt 5):351-367.

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