Addison's disease Flashcards
1
Q
What is the definition of addisons disease?
A
Primary adrenal insufficiency
2
Q
How common is addisons disease?
A
Rare. Incidence about 1 in 10,000 people
3
Q
What is the pathophysiology of addison’s disease?
A
- Adrenal gland does not produce enough glucocorticoid and mineralocorticoid (aldosterone) due to destruction of adrenal cortex
- Autoimmune – antibodies against steroid 21-hydroxylase can be found in 85% of patients
4
Q
What is the aetiology/risk factors for addison’s disease?
A
- Autoimmune diseases
- Corticosteroid withdrawal – causes atrophy of the adrenal gland
- Genetic
5
Q
What are the signs/symptoms of addison’s disease?
A
- ‘Lean, tanned, tired and tearful’
- Weakness
- Anorexia
- Dizzy/faint
- Myalgia/arthralgia
- Depression/psychosis/low self esteem
- Nausea/vomiting
- Abdominal pain
- Diarrhoea/constipation
- Pigmented palmar creases and buccal mucosa
- Postural hypotension
- Vitiligo – pale patches on skin
6
Q
What investigations are carried out for suspected addison’s disease?
A
- ↑ K+, ↓ Na+
- ↓ glucose
- ↑ urea
- ↑ Ca2+
- ↑ Eosinophils
- ↓ FBC (anaemia)
- ACTH stimulation test/Synacthen test: test plasma cortisol before and 30 mins after tetracosactide. Test is +ve is 30 min cortisol <550nmol/L
- Plasma renin and aldosterone
7
Q
What are the pharmacological treatments for addison’s disease?
A
- Hydrocortisone daily
* Fludrocortisone
