http___hr.265health.com_conditions-treatments_rare-diseases_1016046047.html_1.xml
1.1 2.1 2.2 2.3 2.4 3.1 3.2 3.3 3.4 3.5 4.1 4.2 4.3 5.1 6.1 7.1 7.2 7.3 8.1 9.1 10.1 10.2 10.3 10.4 10.5 10.6 11.1 11.2 12.1 12.2 13.1 14.1 14.2 14.3 14.4 15.1 16.1 17.1 17.2 17.3 18.1 18.2 19.1 20.1 20.2 20.3 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 22.1 22.2 22.3 22.4 22.5
causes Primary adrenal insufficiency: Addison's disease can be caused by a primary adrenal insufficiency. This type of deficiency occurs when the adrenal cortex is damaged and does not produce enough cortisol. Adrenal insufficiency occurs when at least 90% of the adrenal cortex (outer layer of the adrenal glands) has been destroyed. Several conditions, including autoimmunity, polyendocrine deficiency syndrome, and tuberculosis infection, can lead to primary adrenal insufficiency. Autoimmune disorders that lead to the gradual destruction of the adrenal cortex are responsible for about 70% of Addison's disease cases. Autoimmune disorders occur when the immune system mistakenly attacks the body's cells because they are identified as foreign cells. The body tries to destroy healthy tissue because the immune system identifies the cells as harmful invaders like bacteria. As a result, often both cortisol and aldostertone hormones are deficient. Sometimes only the adrenal glands are affected, and sometimes other glands (like the pituitary gland) are also affected. The polyendocrine deficiency syndrome is another type of primary adrenal insufficiency that may also lead to Addison's disease. This occurs when other organs, in addition to the adrenal glands, do not secrete enough hormones, including cortisol. There are two forms of polyendocrine deficiency - type I and type II (Schmidt's disease). Type I occurs in children and adrenal insufficiency may be accompanied by underactive parathyroid glands (glands in front of the neck that regulate calcium in the blood), slow sexual development, pernicious anemia (low levels of red blood cells caused by inability to absorb vitamin B12), chronic candida infections (yeast infections), chronic active hepatitis (liver infection), and hair loss (very rare). Type II, commonly called Schmidt's syndrome, typically affects young adults. Common symptoms of type II polyendocrine deficiency syndrome may include slow sexual development, diabetes, and vitiligo (white patches of skin). Some patients may have an underactive thyroid, which often causes symptoms such as fatigue, sensitivity to cold, coarse and thinning hair, brittle nails, sore muscles, depression, weight gain, constipation, and/or heavy or irregular menstrual periods. Tuberculosis (TB), a bacterial infection of the lungs that can spread to the adrenal glands, accounts for about 20% of cases of primary adrenal insufficiency in developed countries, such as the United States. Less common causes of primary adrenal insufficiency, which can lead to Addison's disease, include chronic infection (usually fungal infections), cancer cells spreading from other parts of the body to the adrenal glands, amyloidosis (disease that causes an abnormal protein to build up in the body's tissues and organs), and surgical removal of the adrenal glands. Secondary adrenal insufficiency: Secondary adrenal insufficiency occurs when the adrenal glands are healthy, but factors outside of the adrenal glands stimulate them to produce less cortisol. The most common cause of secondary adrenal insufficiency occurs when patients who are taking cortisol-like drugs (corticosteroids) for chronic conditions like asthma or arthritis suddenly stop taking the medication. These drugs, which can be inhaled or taken orally or intravenously (injected into the vein), suppress the hypothalamic corticotropin releasing hormone (CRH) and adrenocorticotropic hormone (ACTH). CRH stimulates the release of ACTH, which then stimulates the adrenal glands to release cortisol hormones. Prolonged suppression of the adrenal glands can lead to atrophy (shrinkage) and it may take several weeks to months for the patient to recover to full function after the drug is discontinued. Therefore, patients should slowly taper off the mediation under the supervision of their healthcare providers. Secondary adrenal insufficiency can also occur if the pituitary gland does not produce adequate amounts of ACTH, the chemical that signals the adrenal glands to release cortisol. Consequently, individuals who have low levels of ACTH will also have low levels of cortisol, even if the adrenal glands are healthy. Stress: Patients who have untreated Addison's disease may experience Addisonian crisis, also known as acute adrenal failure, in response to physical stress, such as an injury, infection, or illness. This is a serious condition that can be life threatening. symptoms Symptoms are the same for primary and secondary adrenal insufficiency that cause Addison's disease. Symptoms typically develop slowly, often over several months. Physical stress, such as injury, infection, or illness, can cause symptoms to appear suddenly. Common symptoms include muscle weakness and fatigue, weight loss and decreased appetite, darkening of the skin, low blood pressure, fainting, cravings for salt, low blood sugar levels, irritability, depression, diarrhea, nausea, and vomiting. Symptoms of acute adrenal failure (Addisonian crisis) may also include lower back pain, abdominal pain, leg pain, low blood pressure, loss of consciousness, and severe vomiting and diarrhea that can lead to dehydration. diagnosis General: If it is suspected that a patient has Addison's disease, a healthcare provider may measure the cortisol levels of the patient's blood in the morning (usually between 6 and 8:00 a.m.). Healthy individuals typically have plasma cortisol levels that range from 5-23 micrograms/deciliter. Plasma cortisol levels less than 10 micrograms/deciliter are suggestive of Addison's disease. However, the standard diagnostic test for Addison's disease is the adrenocorticotropic hormone (ACTH) stimulation test. If a patient tests positive for Addison's disease, a healthcare provider may then perform a corticotropin releasing hormone (CRH) stimulation test and/or imaging studies (scans that take pictures of the body's internal organs) to determine the cause of the disease. Adrenocorticotropic hormone (ACTH) stimulation test: The adrenocorticotropic hormone (ACTH) test measures the level of cortisol in the blood and urine before and 30-60 minutes after an injection of man-made ACTH. Individuals who do not have adrenal damage will begin producing cortisol in response to the injection. Patients with Addison's disease will produce minimal or no cortisol in response to the injection. Corticotropin releasing hormone (CRH) stimulation test: If the patient tests positive to the ACTH test, a corticotropin releasing hormone (CRH) stimulation test is conducted to determine the cause of adrenal insufficiency. The patient's cortisol levels are measured in the urine and blood before the test. Then, a man-made CRH is injected intravenously into the patient. Cortisol levels in the blood and urine are then measured 30, 60, 90, and 120 minutes after the injection. Patients with primary adrenal insufficiency have high levels of ACTH but do not produce cortisol. Patients with secondary adrenal insufficiency have will have very low cortisol levels in response to the injection and absent or delayed ACTH responses. Absent ACTH response indicate that the pituitary gland is causing the disease. A delayed ACTH response indicates that the hypothalamus (part of the brain that controls the release of hormones from the pituitary gland) is the cause. Imaging tests: Imaging studies, including computerized tomography (CT) and magnetic resonance imaging (MRI) scans, may be conducted at the hospital after a patient shows low levels of cortisol in response to the ACTH stimulation test. During these procedures, which are generally noninvasive and painless, pictures of the internal organs are taken with machines that use X-rays and magnetic waves. The healthcare provider will check the size of the adrenal glands and pituitary glands. If the adrenal glands are smaller than normal, this indicates that primary adrenal insufficiency is the cause. If the pituitary gland is smaller than normal, this indicates that secondary adrenal insufficiency is the cause.
1.1 1.2 2.1 3.1 3.2 3.3 4.1 6.1 6.2 6.3 6.4 6.5 6.6 6.7 7.1 8.1 8.2 8.3 8.4 8.5 9.1 10.1 10.2 10.3 10.4 11.1
Pojedinci koji su oboljeli od nadbubrežne insuficijencije općenito primijetiti simptome razvija tijekom razdoblja od nekoliko mjeseci . Simptomi su umor , slabost mišića, smanjen apetit , gubitak težine, nizak krvni tlak, žudnja za soli , nisku razinu šećera u krvi , zamračenja kože , razdražljivost, depresija i bol u zglobovima /mišića . Iznenadne krizni simptomi osoba s nadbubrežne insuficijencije mogu ići u ono što se zove" akutna adrenalna neuspjeh " obično nazivaaddisonian kriza u medicinske zajednice . Addisonian kriza može dovesti do bolesti, infekcija , stresa ili ozljede i trebao bi se smatrati život opasne medicinske hitne koje bi mogle dovesti do smrti ako liječenje nije odmah dobio . Simptomi se pojavljuju iznenada i uključuju bol u trbuhu , noge i donji dio leđa , proljev i povraćanje teška , nizak krvni tlak , gubitak svijesti i visoka kalija . Testovi /Dijagnoza Postoje testovi koji se mogu primijeniti kako bi vidjeli ako imate adrenalna insuficijencija . Krvni testovi se izvodi za mjerenje antitijela koje su povezane s Addison -ova bolest . Ovi testovi će mjeriti kalij, natrij , kortizola i ACTH razine krvi u . Ostali testiranje može uključivati snimanja, kao što su MRI ili CT , da vidi svoje nadbubrežne i hipofize . ACTH stimulaciju ispitivanje može provesti . To uključuje primanje injekciju sintetskog ACTH i mjerenje razine kortizola u krvi prije i poslije injekcije . Rezultati će pomoći liječnici utvrditi je li se vaše nadbubrežne žlijezde oštećena . Tretman Srpski Srpski tretman za nadbubrežna nedostatnost uključuje kortikosteroide recept . Pojedinci mogu uzeti jedan ili više hormona zamijeniti nedostatak tijela . Hormoni treba uzeti dnevno i pojedinci koji su bolesni ili prolaziti veliki životni stres može imati svoje doze privremeno povećao . Pojedinci koji su postali bolesni , a tko ne može držati dolje svoje oralne lijekove morat će uzeti injekcije . Ljudi koji idu u addisonian krize morat će se intravenozno ubrizgava s hidrokortizonskom , fiziološkom otopinom i dekstroze . Razmatranja ljudi s nadbubrežna nedostatnost treba nositi s medicinskim upozorenjem karticu i nositi s medicinskim upozorenjem nakit, kao što su narukvicu ili ogrlicu koja identificira njihovo stanje . Nedostaje dozu lijekova je opasna i pomoćna lijekove treba držati na ruci u svakom trenutku . Injekcija kortikosteroida i šprica /igala treba čuvati za hitne slučajeve . Osobe s nadbubrežna nedostatnost se savjetuje da održavaju bliske , u tijeku odnosa sa svojim liječnicima . From:http://hr.265health.com/conditions-treatments/rare-diseases/1016046047.html