Addison’s disease

Addison’s disease

An endocrinopathy characterised by decreased production of aldosterone and cortisol.
 
Aetiology
Autoimmunity (90%), trauma, haemorrhage, tuberculosis, pituitary gland destruction, amyloid, infection (e.g., meningococcal septicaemia), surgical excision.
Clinical findings
Weakness, hypotension, easy fatigability, weight loss, nausea, vomiting, abdominal pain, muscle and joint pain, amenorrhea, bronzing of skin and hyperpigmentation (especially at skin folds), scars, palmar creases, loss of body hair.
Lab
Anaemia, neutropenia, eosinophilia, lymphocytosis, hypoglycaemia, reduced Na+, decreased cortisol, increased Ca2+, increased K+, increased BUN, dehydration.
 
Management
Hydrocortisone, fludrocortisone.
 
Warning
Patients should wear medical alert bracelet.