Addison’s disease is a disease of the adrenal cortex caused by autoimmune destruction of the adrenal gland with fibrosis and mononuclear cell infiltration. Symptoms become evident when more than 90% of the adrenal gland is destroyed. Addison’s disease is characterized by increased production of adrenocorticotropic hormone (ACTH) and adrenal insufficiency with reduced production of corticosteroids and androgens. Patients present with hypotension, weakness, fatigue, light headedness when standing up, anorexia, nausea, salt craving and increased melanin pigmentation of the skin.
Addisonian crisis is characterized by:
- Extreme tiredness
- Weak muscles
- Reduced appetite
- Weight loss
- Darkening of the skin (hyperpigmentation)
- Reduced heart rate or low blood pressure
- Light-headedness and fainting
- Salt craving
- Low blood sugar (hypoglycaemia)
- Nausea or vomiting
- Abdominal pain
- Muscle or joint pains
- Body hair loss or sexual dysfunction in women
- Pain in the lower back, abdomen or legs
- Severe vomiting and diarrhea that causes dehydration
- Low blood pressure
- Blood sugar
- Confusion, fear, or restlessness
- Loss of consciousness
- High potassium levels in the blood (hyperkalemia)
- Low sodium levels in the blood (hyponatremia)
The treatment involves replacement of insufficient hormones through hormone replacement therapies.
Highest genetic risk is associated with particular Major Histocompatibility Complex (MHC) alleles, specifically Human Leukocyte Antigen (HLA)-DR3 and HLA-DR4. Genetic testing can offer a better understanding of the origin of the disease, for improved diagnosis and treatment.
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