Addison's Disease

Addison's disease is a rare disorder of the adrenal glands. With Addison's, the adrenal glands do not produce enough of the hormones cortisol and aldosterone.

  • Causes

    Addison's disease is the result of gradual damage to the outer layer of the adrenal gland.
    This damage may be caused by:

    • The body's own immune system attacking the gland—known as an autoimmune disease.
    • Tuberculosis

    • Bleeding within the adrenal glands—related to the use of anticoagulant medications and
      shock
    • Surgical complication
    • Conditions that are present at birth or due to genetic factors such as enzyme defects and familial glucocorticoid insufficiency
    • Cytomegalovirus
      (CMV)

      infection
      associated with
      AIDS

    • Fungal infections, including:

      • Blastomycosis
      • Histoplasmosis
      • Coccidioidomycosis

    • Cancer including metastases from:

      • Breast
        ,
        lung
        ,
        kidney
        , or
        colon
        cancer
      • Lymphoma
      • Kaposi's sarcoma
    • Medications such as
      ketoconazole
      or etomidate
    • Radiation
      treatment

    • Chronic illness, including:

      • Sarcoidosis
      • Hemochromatosis
      • Amyloidosis
      • Adrenoleukodystrophy
      • Adrenomyelodystrophy

  • Definition

    Addison's disease is a rare disorder of the adrenal glands. With Addison's, the adrenal glands do not produce enough of the hormones cortisol and aldosterone.

    Adrenal Glands
    nucleus factsheet image
    Addison's occurs because of damage to the cortex.
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.

    Your bodily fluids may be tested. This can be done with:

    • Blood tests
    • Urine tests
    • ACTH stimulation test

    Your doctor may also need images of your bodily structures.
    This can be done with:

    • MRI scan
    • CT scan

  • Prevention

    There are no guidelines for preventing Addison's disease. If you think you are at risk, talk to your doctor.

  • Risk Factors

    Factors that increase your chance of getting Addison's disease include:


    • Having the following autoimmune diseases:

      • Type I diabetes

      • Pernicious
        anemia
      • Hypoparathyroidism
      • Hypopituitarism
      • Hyperthyroidism
        or
        hypothyroidism
      • Myasthenia gravis
    • Stress
    • Anticoagulant medications
    • Abdominal injury
    • Family members with autoimmune-caused Addison's disease

    • Long-term steroid medication treatment, followed by:

      • Severe stress
      • Infection
      • Surgery
      • Trauma
    • Previous surgery on adrenal glands
    • Hereditary disorders, such as Prader-Willi syndrome and congenital adrenal hyperplasia

  • Symptoms

    Symptoms may include:

    • Extreme weakness, fatigue
    • Weight loss
    • Nausea or vomiting

    • Chronic
      diarrhea
    • Muscle weakness
      or pain
    • Darkening of freckles, nipples, scars, skin creases, gums, mouth, nail beds, and vaginal lining

    • Emotional changes, especially
      depression
    • Cognitive impairment or confusion
    • Craving salty foods
    • Abdominal pain
    • Anorexia
    • Amenorrhea


    A severe complication of Addison's disease is the Addisonian or
    adrenal crisis
    . Adrenal crisis is a life threatening disorder, its symptoms include:

    • High or low body temperature
    • Severe abdominal, back, or leg pain
    • Fainting
    • Severe dehydration
    • Severe nausea, vomiting, and diarrhea
    • Bluish skin color
    • Muscle weakness

  • Treatment

    Symptoms of Addison's disease can be controlled with medications. These drugs replace the missing hormones. Medication needs to be taken for the rest of your life. They may need to be increased during times of stress.

    Immediate treatment of adrenal crisis includes:

    • Self-injection of dexamethasone
    • Hydrocortisone by IV
    • Normal saline by IV

    Surgery may also be needed for adrenal tumors or pituitary tumors causing the disease.