Addison's Disease Flashcards
What is the most common cause of hypoadrenalism?
Autoimmune - caused by lymphocytic adrenalitis
Why do patients with Addison’s disease appear hyperpigmented?
ACTH secretion is greatly increased in an attempt to stimulate the dysfunctional adrenal glands to secrete cortisol. Therefore serum ACTH levels are very high.
ACTH contains melanocyte-stimulating hormone-like sequences causing pigmentation.
What are some of the symptoms of Addison’s disease? (12)
- Weight loss
- Weakness
- Lethargy/Malaise
- Abdo pain
- Nausea
- Diarrhoea/constipation
- Hypotension
- Confusion
- Fever
- Depression
- Myalgia/arthralgia
- Impotence
What are the signs of Addison’s disease? (8)
- Pigmentation (esp. of new scars/palmar creases)
- Buccal pigmentation
- Dehydration
- Postural hypotension
- Weight loss
- Loss of body hair
- General wasting
- Vitiligo
What pattern is classically seen on U&Es of a patient with Addison’s Disease?
- Hyponatraemia
- Hyperkalaemia
- High urea
What test is done to diagnose Addison’s disease?
Synacthen test
Tests abilities of adrenals to increase cortisol secretion in response to synthetic ACTH stimulation.
Short synacthen test = measures response over 30 minutes
If no response, ACTH can be given for 24hrs to exclude temporary adrenal suppression (long synacthen test)
What imaging is done in Addison’s Disease? Why?
Abdo CT/MR - to exculde tuberculous calcification and adrenal tumours
What is the acute management of adrenal crisis?
IV hydrocortisone + saline repletion
What is the maintenance therapy for Addison’s disease?
Oral hydrocortisone
What should patients with Addison’s disease be taught?
Increase steroid doses during intercurrent illness
