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ADDISON'S DISEASE

Adrenal cortex secretes glucocorticoid, mineralocorticoid and sex corticoid. Insufficiency of the adrenal cortex secretion mainly affecting glucocorticoid and mineralocorticoid is addison’s disease. It can occur as chronic disease or as acute crisis. 

Symptoms

  • Chronic cause:
  • Hyperpigmented skin
  • Vitiligo
  • Weakness, fatigue
  • Nausea, Vomiting
  • Dizziness
  • Acute crisis
  • Shock
  • Nausea
  • Vomiting
  • Hyperpyrexia

 

Causes

  • Chronic cause
  • Idiopathic autoimmune destruction of adrenal cortex
  • TB
  • HIV/AIDS
  • Bilateral adrenal removal
  • Acute cause

Stress due to infection, trauma, surgery, diarrhea and emotional turmoil

Diagnosis

  • ACTH stimulation test
  • Random plasma cortisol
  • Serum electrolytes

Complications

  • Electrolyte imbalance ( increased potassium, decreased sodium)
  • Shock
  • Hypoglycemia

Treatment

  • Chronic onset:
  • Glucocorticoid replacement: hydrocortisone is the drug of choice
  • Mineralocorticoid replacement: fludrocortisones is administered
  • Adrenal crisis:
  • Iv fluids
  • Glucocorticoids replacement: iv hydrocortisone
  • Correct electrolyte imbalance:
  • Identify and treat cause