ADDISONS DISEASE

AFIF BIN AIDIT 082013100004 IMS BANGALORE

LEARNING OUTCOMES
What is Addisons disease

Pathogenesis
Causes Clinical manifestation

Investigations
Treatments

DEFINITION
Body produces insufficient amount of cortisol or

aldesterone an autoimmune inflammation of adrenal gland resulting in gradual destruction inability to make sufficient amounts of adrenal hormones. Fatal Known as adrenal insufficiency Occurs in all groups and both sexes

PATHOGENESIS
Occurs when more than 90% of adrenal gland tissue

is destroyed Primary Addisons disease Due to autoimmune system, tuberculosis

CAUSES
PRIMARY SECONDARY

1) 2) 3) 4) 5) 6) 7)

Polyglandular syndrome Tuberculosis HIV/AIDS Metastatic carcinoma Bilateral adrenalectomy Amyloidosis Intra-adrenal haemorrhage

1) Withdrawal of suppressive glucocorticoid therapy 2) Hypothalamic or pituitary disease

CLINICAL MANIFESTATIONS
GLUCOCORTIC OID INSUFFICINEC Y 1) 2) 3) 4) 5) MINERALCORT ICOID INSUFFICIENC Y ACTH EXCESS ADRENAL ANDROGEN INSUFFICIENC Y 1) Decreased body hair 2) Loss of libido, especially in female

Weight loss 1) Hypotension Malaise 2) Hyponatremia Weakness 3) Hyperkalemia Diarrohea Postural hypotension 6) Hypoglycaemia 7) Hyponatremia 8) Hypercalcaemi a

1) Pigmentation : - palmar crease - knuckles - conjunctivae

INVESTIGATIONS
Random blood sample ( cortisol )

ACTH stimulation test

Assessment of mineralcorticoids Plain x-ray

Ultrasound
HIV test

TREATMENTS
Glucocorticoid replacement therapy

Adrenal androgen ( women )

Mineralocorticoid replacement

REFERENCE
http://www.mayoclinic.org/diseases-

conditions/addisons-disease/basics/definition/con20021340 http://autoimmune.pathology.jhmi.edu/diseases.cf m?systemID=3&DiseaseID=16