Addison’s Disease (Adrenacortical Insufficiency)

Addison’s Disease (adrenacortical insufficiencies) happen when the underactive adrenal gland produces insufficient amounts of corticosteroids. Addison’s Disease affects approx. four Addison's Diseaseout of every 100,000 individuals. Such a disorder may occur at any age and is known to affect men and women almost equally. In 30% of individuals with Addison’s Disease , the adrenal gland is destroyed by an tuberculosis, amyloidosis, cancer, or other disorders. In the remaining 70%, the cause is not known exactly, but researchers suggest that adrenal gland is destroyed by an autoimmune reactions.

The adrenal gland is also suppressed in individuals taking a corticosteroid such as prednisone, while corticosteroid deficiency may cause high level of potassium level or low sodium levels in the blood, inability to concentrate urine, dehydration, extreme sensitivity to insulin, muscle weakness, heart weakness, or in severe cases-shock. Soon after the progression of Addison Disease, a patient feels tired, weak and dizzy, when standing up after lying down or sitting. The person’s skin becomes dark and darkness appears on both non exposed and sun exposed body parts. Black freckles can progress over the shoulders, face and forehead; and a bluish-black discolorations can progress around vagina, nipples, scrotium, lips, rectum, and mouth. Most individuals develop diarrhea, muscle pain, vomiting, and nausea; and become dehydrated, lose weight, and lose appetite. Many cannot tolerate cold.

Addison’s Disease tends to become apparent only during stress periods, until the disease is severe. If the Addison Disease is not treated, kidney failure, abdominal pain, low blood pressure levels, shock, and profound weakness can occur. The disease become life threatening at this point. Because the symptoms of Addison’s Disease can be subtle and begin slowly; and because no single laboratory tests are definitive, doctors frequently do not suggest Addison Disease at the earlier stages.

In some cases, serious illness, major stress, surgery, or accident make the symptoms more visible and are precipitating a crisis. Blood tests can reveal corticosteroid deficiency (particularly – Cortisol), as well as high potassium levels and low sodium levels. Tests for creatine and blood urea may reveal that the kidneys are not functioning well. Challenge test (performed after corticotropin injection), may help doctors distinguish pituitary gland insufficiency from adrenal gland insufficiency. When it’s the latter, corticotropin-releasing hormone injection shows whether the problem is sufficiency of hypothalamus.

Regardless of the causes, Addison’s Disease may be life threatening and should be treated first with a Corticosteroid. Generally,treatment may begin by taking Prednisone orally; however, patients with severe Addison’s Disease can be given cortisol intravenously at the beginning and then-prednison by mouth. Most individuals with this disease also require to take one or two tablets of fludrocortisone daily to restore the body’s normal potassium and sodium excretion. LargerĀ  Prednisone doses can be required when the person’s body is stressed, particularly from an illnesses. The treatment should last for a lifetime and the prognosis for a normal life is good.

Explanation Video of Addison’s Disease

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