Addison's Disease Flashcards
What is it?
Primary adrenocortical insufficiency resulting in a lack of production of steroid hormones
What steroids are implicated? (3)
Glucocorticoids e.g Cortisol, Mineralocorticoids e.g Aldosterone, Androgens e.g Testosterone
What is the most common cause?
80% are caused by autoimmune disease
What are the other causes? (7)
TB, Adrenal metastases, lymphoma, opportunistic infections, adrenal haemorrhage, congenital, LONG TERM IATROGENIC STEROID USE
What is the autoantibody seen in addisons disease?
21 Hydroxylase
Is it common?
No it is relatively rare-1 in 10,000 people
Who is affected?
It can affect all age groups but is most common in 30-50 year olds and affects more women
Symptoms (16)
Lean, tanned, tired, tearful, weakness, anorexia, dizziness, fainting, flu like aches, depression, low self esteem, nausea, vomiting, abdominal pain, diarrhoea, constipation
Signs (8)
Pigmented palmar creases, pigmented buccal mucosa, postural hypotension, vitilligo, shock, hypovolaemia, tachycardia, temperature, coma
What bloods would you do? (6)
FBC, U&E (high potassium, low sodium), LFT, Glucose (low), Calcium (high), Cortisol
Other investigations (4)
ACTH stimulation tests, 21 Hydroxylase Adrenal Autoantibodies, Plasma renin and aldosterone, Cortisol
What is the treatment? (3)
Steroid replacement therapy e.g 15-25mg Hydrocortisone, mineralocorticoids to correct postural hypotension and electrolyte balance e.g Fludrocortisone 200mg, patient education about addisonian crises
Complications (3)
Adrenal Crisis, Reduced quality of life due to fatigue, osteoporosis
Is there a good prognosis? (4)
Lose several years of life expectancy, treatment is lifelong, more susceptible to infection, risk of sudden death
