Centres of Excellence -> Endocrinology and Diabetes -> Addison's disease

Addison's disease

Addison's disease is named after the British doctor Thomas Addison, who first described it in 1885. It is a reduced function of the cortex of the adrenal gland, which manifests itself in the reduced production and secretion of its hormones: aldosterone, cortisol and sex hormones originating from the adrenal gland (adrenal androgens). It usually occurs between the ages of 30 and 50 with equal distribution in both genders.

When and how does Addison's disease occur?

It most often occurs as a result of autoimmune inflammation of the adrenal cortex (autoimmune adrenalitis), while other factors include infection of the adrenal cortex with microorganisms (viruses, bacteria and fungi), destruction of the adrenal cortex by a malignant process (adrenal cortex cancer) or metastases of other malignant tumors, tuberculous process or other diseases (sarcoidosis) and infiltrative diseases (amyloidosis, hemochromatosis, Wilson's disease).

Also, the use of some medicines (ketoconazole, busulfan, methadone), ionizing radiation, circulatory disorders with bleeding and thrombosis (sepsis, bacteremia) can lead to insufficiency of cortex of the adrenal glands. Congenital causes of Addison's disease arise due to gene mutations involved in the processes of creating hormones of the adrenal cortex.

Symptoms of Addison's disease

The symptoms that occur in patients are directly related to the lack of these hormones. A lack of aldosterone causes a reduced level of sodium and an increased level of potassium in the body, resulting in muscle weakness, heart arrhythmias, dehydration and low blood pressure (arterial hypotension), which is accompanied by dizziness, light headedness, headaches and ringing in the ears. Renal function also gradually weakens. Cortisol deficiency leads to low blood sugar (hypoglycemia), fatigue, general weakness, weight loss and unclear abdominal pains accompanied by nausea and vomiting. Resistance to infections and stress is reduced.

As a reaction, an excess ot the adenocorticotropic hormone is secreted from the pituitary gland, which stimulates increased production of the skin pigment melanin, so the patients have a dark skin color. Lack of adrenal androgens is manifested in women by hair loss  with the cessation of menstruation and in men, a decrease in libido and impotence may occur. In a certain number of patients, Addison's disease can be diagnosed along with other autoimmune diseases, such as Hashimoto's disease, vitiligo, type 1 diabetes, celiac disease, multiple sclerosis, rheumatoid arthritis, etc. Then the clinical presentation is combined with the symptoms and signs of the mentioned diseases.


Diagnosis and treatment

The diagnostic procedure includes a specialist examination, laboratory and hormonal tests, assessment of antibodies, radiological procedures such as ultrasound or MR and sometimes genetic testing. Addison's disease is treated medicinally with additional treatment of the underlying causal process.

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