AFI F BI N AI DI T

08201 31 00004
I MS BANGALORE
ADDISONS DISEASE
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) Polyglandular syndrome
2) Tuberculosis
3) HIV/AIDS
4) Metastatic carcinoma
5) Bilateral adrenalectomy
6) Amyloidosis
7) Intra-adrenal haemorrhage
1) Withdrawal of suppressive
glucocorticoid therapy
2) Hypothalamic or pituitary disease
CLINICAL MANIFESTATIONS
GLUCOCORTIC
OID
INSUFFICINEC
Y
MINERALCORT
ICOID
INSUFFICIENC
Y
ACTH EXCESS ADRENAL
ANDROGEN
INSUFFICIENC
Y
1) Weight loss
2) Malaise
3) Weakness
4) Diarrohea
5) Postural
hypotension
6) Hypoglycaemia
7) Hyponatremia
8) Hypercalcaemi
a
1) Hypotension
2) Hyponatremia
3) Hyperkalemia

1) Pigmentation :
- palmar crease
- knuckles
- conjunctivae
1) Decreased body
hair
2) Loss of libido,
especially in
female
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/con-
20021340
http://autoimmune.pathology.jhmi.edu/diseases.cf
m?systemID=3&DiseaseID=16