Addison’s Disease Explained: Causes, Symptoms, Diagnosis & Treatment
Question. Write briefly on Addison’s disease.
Answer. Addison’s disease or primary hypoadrenalism results from the destruction of the adrenal cortex by a variety of pathological processes.
Addison’s Disease Etiology
- It is caused due to autoimmune adrenalitis.
- Infections, i.e. TB, cytomegalovirus, and fungal infection, are associated with AIDS.
- By tumors
- Inherited disorders, i.e. adrenoleukodystrophies and familial isolated glucocorticoid defiiency.
Addison’s Disease: Causes, Symptoms, Diagnosis, and Treatment
Clinical Features Of Addison’s Disease
- Pigmentation of skin and mucus membrane: There is bluish-black discoloration of lips, gums, and the posterior aspect of the palate.
- Gastrointestinal symptoms: Anorexia, nausea and vomiting.
- Constipation with intermittent diarrhea, achlorhydria, and abdominal pain
- Cardiovascular system: Postural hypotension and faintness may result. Dyspnea is also present.
- Muscular system: Muscular weakness and wasting with creatinuria. Sometimes cramps in muscles are present.
- Mental and nervous: Muscle weakness and lassitude (exhaustion) are the first symptoms to appear. Loss of memory and drowsiness.
- Genital system: Impotence and *amenorrhea are present.
- Renal system: Renal function is impaired and the excretion of urine is diminished.
Causes of Addison’s Disease and Its Symptoms
Investigation Of Addison’s Disease
- Serum sodium and chloride levels are decreased
- The blood sugar level is decreased
- Blood urea increases
- Urine secretion of chloride is increased.
- Urinary secretion decreases
- BMR is decreased
- Abdominal X-ray shows calcification of the adrenal gland.
Treatment Of Addison’s Disease
- Cortisone substitution: Hydrocortisone 20 mg TDS for 72 hours. For maintenance, the dose is 20 mg in the morning and 10 mg in the evening.
- Aldosterone substitution: Fludrocortisone 50 μg BD is started.
- Salt: Patients with diarrhea or profuse sweating should be given an additional 3–6 gm of sodium chloride daily.
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