Addison's Disease

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Definition/Description

Addison’s disease is another name for primary chronic adrenal insufficiency.  It is a condition where the adrenal cortex (the outer layer of the adrenal gland that produces mineralocorticoids, glucocorticoids, and androgens) is progressively destroyed, resulting in decreased secretions of the hormones.  Cortisol, a glucocorticoid, and aldosterone, a mineralcorticoid, are the primary hormones that are decreased with this disease, causing body wide metabolic disorders and fluid imbalances.

Prevalence

Addison’s disease occurs in about 4 out of 100,000 Americans each year.  Even though it is seen throughout the lifespan in both genders, it most commonly occurs in middle-aged white females.

Characteristics/Clinical Presentation

Addison’s disease will develop insidiously, with the signs of the disease not developing “until at least 90% of both glands is destroyed and the levels of circulating glucocorticoids and mineralocorticoids are significantly decreased.”2  Some of the clinical signs and symptoms of Addison’s disease include:

• Darkened pigmentation of the skin, due to increased secretion of melanin-secreting hormone (MSH) corresponding with increased secretion of ACTH, which is released to try to stimulate the work of the adrenal glands1,2, 

• Slowly developing weakness and fatigue2,3

• Hypotension due to increased sodium excretion from decreased aldosterone secretion1,2,3

• Severe abdominal, low back, or leg pain1

• Gastrointestinal disturbances such as nausea, vomiting, anorexia, weight loss, and diarrhea2,3

• Hypoglycemia due to decreased glucocorticoids causing decreased gluconeogenesis1,2

• Decreased stress tolerance (infections, trauma, surgery, etc.)1,2

• Salt craving

 

Associated Co-morbidities

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Medications

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Diagnostic Tests/Lab Tests/Lab Values

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Causes

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Systemic Involvement

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Alternative/Holistic Management (current best evidence)

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Differential Diagnosis

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Case Reports

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Resources

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Recent Related Research (from Pubmed)

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References

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