Addison's Disease

What is Addison's Disease?

Addison's Disease is a disease of the Adrenal glands. The adrenal glands are two small glands located atop each respective kidney, weighing only 8-10 grams together. The adrenal glands are divided into an outer cortex, and an inner medulla. The cortex is divided into three zones (reticulata, fasciculata, glomerulosa) and each produces different types of hormones - glucocorticoids, mineralocorticoids, and sex steroids. Addison's disease occurs when the adrenal cortex does not produce enough of the three types of hormones - glucocorticoids, mineralocorticoids, and sex steroids.

Statistics on Addison's Disease?

About 1 in 100,000 people. It occurs in all age groups and afflicts men and women equally. Requires destruction of at least 90% of Adrenal Cortex. One sufferer who really brought Addisons to the front of peoples minds was John F. Kennedy, as he himself suffered from the condition.

Risk Factors for Addison's Disease

In 60-70% of cases Autoimmune Adrenalitis

Infections, particulary tuberculosis and those produced by fungi.

Progression of Addison's Disease

Adrenocortical insufficiency caused by gradual adrenal destruction is charcterized by an insidious onset of fatigability, weakness, anorexia, nausea and vomiting, weight loss, cutaneous and mucosal pigmentation, hypotension, and occasionally hypoglycaemia. Depending on the duration and degree of adrenal hypofunction, the manifestations vary from mild chronic fatigue to fulminating shock associated with acute destruction of the glands (adrenal crisis), as described by Waterhouse and Friderichsen. The crisis is often precipitated by intercurrent disease, surgery, or infection. All patients with adrenal insufficiency should receive specific hormone replacement.

How is Addison's Disease Diagnosed?

A full blood count will be taken.

Prognosis of Addison's Disease

Normal lifespan if treated

How is Addison's Disease Treated?

Treatment of Addison's disease involves replacing, or substituting, the hormones that the adrenal glands are not making. Cortisol is replaced orally with hydrocortisone tablets, a synthetic glucocorticoid, taken once or twice a day. If aldosterone is also deficient, it is replaced with oral doses of a mineralocorticoid, called fludrocortisone acetate (Florinef), which is taken once a day.

Addison's Disease References

[1] Addison Disease as retrieved from www.niddk.nih.gov on 9/12/2003 [2] Ballinger, A. Patchett, S., Saunders' Pocket Essentials of Clinical Medicine 2nd ed. W.B. Saunders, 2000 [3] Haslett, Chilvers, Boon, Colledge. DAVIDSON'S PRINCIPLES & PRACTICE OF MEDICINE. Churchill Livingstone. 2002. [4] Kumar P, Clark M. CLINICAL MEDICINE. WB Saunders 2002, [5] Longmore M, Wilkinson I, Torok E. OXFORD HANDBOOK OF CLINICAL MEDICINE. Oxford Universtiy Press. 2001 [6] Robbins, S.L., Cotran, R.S., Kumar, V. Robbins Pathologic Basis of Disease 5th ed. W.B. Saunders 1995.