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{{Addison's disease}}
{{Addison's disease}}
 
{{CMG}} ; {{AE}} {{ADG}}
{{CMG}}
 
==Overview==
==Overview==
Addison's disease often has an insidious onset. In many cases, the disease is only recognized when the patient presents with an acute crisis precipitated by a stressful [[illness]] or situation. Acute adrenal insufficiency should be considered in patients presenting with [[abdominal pain]], [[nausea]], [[diarrhea]], [[hypotension]], and [[fever]]. A detailed and thorough history is necessary. Specific areas of focus when obtaining a history from the patient of Addison's disease include recent changes in diet, any signs of [[postural hypotension]] and history of [[cancer]] or other autoimmune diseases, [[tuberculosis]] or any exposure to anyone who has been diagnosed with [[tuberculosis]].


==History==
A detailed and thorough history from the patient is necessary. Specific areas of focus when obtaining a history from the patient of Addison's disease include:<ref name="pmid22907517">{{cite journal |vauthors=Quinkler M |title=[Addison's disease] |language=German |journal=Med Klin Intensivmed Notfmed |volume=107 |issue=6 |pages=454–9 |year=2012 |pmid=22907517 |doi=10.1007/s00063-012-0112-3 |url=}}</ref>
*Recent changes in diet
**Patients with Addison disease often crave salty foods and are often [[Anorexia|anorexic]]
*Irregular [[menstruation]]
**[[Oligomenorrhea]] or [[amenorrhea]] are features of Addison disease
*Any signs of [[postural hypotension]]
*Any recent changes in [[weight]]
*History of [[tuberculosis]] or any exposure to someone with [[tuberculosis]]
*History of [[malignancy]]
*History of other [[autoimmune disease]], such as [[Graves' disease|Graves disease]], [[Hashimoto's thyroiditis]], [[hypoparathyroidism]], [[vitiligo]], [[pernicious anemia]] or [[diabetes mellitus]]
*[[Family history]] of Addison's disease or any other [[Adrenal gland|adrenal]] disorder


==History and Symptoms==
==Symptoms==
===Symptoms===
Addison's disease often has an insidious onset. In many cases the disease is only recognized when the patient presents with an acute crisis precipitated by a stressful illness. Acute adrenal insufficiency should be considered in patients presenting with [[abdominal pain]], [[nausea]], [[diarrhea]], [[hypotension]] and [[fever]].<ref name="pmid23633816">{{cite journal |vauthors=Sarkar SB, Sarkar S, Ghosh S, Bandyopadhyay S |title=Addison's disease |journal=Contemp Clin Dent |volume=3 |issue=4 |pages=484–6 |year=2012 |pmid=23633816 |pmc=3636818 |doi=10.4103/0976-237X.107450 |url=}}</ref><ref name="pmid12788587">{{cite journal |vauthors=Arlt W, Allolio B |title=Adrenal insufficiency |journal=Lancet |volume=361 |issue=9372 |pages=1881–93 |year=2003 |pmid=12788587 |doi=10.1016/S0140-6736(03)13492-7 |url=}}</ref>
===Common Symptoms===
*[[Weakness]]
*[[Fatigue|Chronic fatigue]]
*[[Weight loss]]
*[[Anorexia]]
*[[Nausea]]
*[[Vomiting]]
*[[Diarrhea]]
*Intolerance of temperature extremes
*[[Abdominal pain]]
*[[Amenorrhea]]
*Craving for salty foods
*[[Depression]]
*[[Dizziness]]
===Symptoms of Addisonian crisis===
Symptoms of Addisonian crisis include:
*[[Dizziness]], [[generalized weakness]] ([[fatigue]])
*[[Anorexia]]
*Sharp, sudden [[pain]] in the [[abdomen]], [[legs]], or [[lower back]]
*Severe [[vomiting]] and [[diarrhea]]
*[[Dehydration]]
*Loss of [[consciousness]]
*[[Hypoglycemia]]


The symptoms of adrenal insufficiency develop insidiously, usually begin gradually and it may take some time to be recognized. Some have marked cravings for salty foods due to the urinary losses of sodium. Characteristics of the disease are
==References==
 
{{Reflist|2}}
* Chronic, worsening fatigue
* [[Muscle weakness]]
* [[Loss of appetite]]
* [[Weight loss]]
* [[Headache]]
* [[Sweating]]
* Changes in mood and personality
* [[Myalgia|Muscle pains]]
* [[Arthralgia|Joint pains]]
 
About 50 percent of the time, one will notice:
 
* [[Nausea]]
* [[Vomiting]]
* [[Diarrhea]]


'''Other symptoms include:'''
[[Category:Endocrinology]]
:* [[Low blood pressure]] that falls further when standing, causing dizziness or fainting
[[Category:Disease]]
:* Skin changes in Addison's disease, with areas of [[hyperpigmentation]], or dark tanning, covering exposed and nonexposed parts of the body; this darkening of the skin is most visible on scars; skin folds; pressure points such as the elbows, knees, knuckles, and toes; lips; and mucous membranes
[[Category:Medical emergencies]]
 
[[Category:Emergency medicine]]
[[Addison's disease]] can cause irritability and depression. Because of salt loss, a craving for salty foods also is common. [[Hypoglycemia]], or [[low blood glucose]], is more severe in children than in adults. In women, menstrual periods may become irregular or stop.
[[Category:Intensive care medicine]]
Because the symptoms progress slowly, they are usually ignored until a stressful event like an illness or an accident causes them to become worse. This is called an [[addisonian crisis]], or [[acute adrenal insufficiency]]. In most cases, symptoms are severe enough that patients seek medical treatment before a crisis occurs. However, in about 25 percent of patients, symptoms first appear during an addisonian crisis.
[[Category:Needs overview]]
 
'''Symptoms of an addisonian crisis include:'''
:* Sudden penetrating pain in the lower back, abdomen, or legs
:* Severe vomiting and diarrhea
:* [[Dehydration]]
:* Low blood pressure
:* [[Loss of consciousness]]
Left untreated, an addisonian crisis can be fatal.
 
==References==
{{reflist|2}}


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Latest revision as of 20:13, 11 October 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Addison's disease often has an insidious onset. In many cases, the disease is only recognized when the patient presents with an acute crisis precipitated by a stressful illness or situation. Acute adrenal insufficiency should be considered in patients presenting with abdominal pain, nausea, diarrhea, hypotension, and fever. A detailed and thorough history is necessary. Specific areas of focus when obtaining a history from the patient of Addison's disease include recent changes in diet, any signs of postural hypotension and history of cancer or other autoimmune diseases, tuberculosis or any exposure to anyone who has been diagnosed with tuberculosis.

History

A detailed and thorough history from the patient is necessary. Specific areas of focus when obtaining a history from the patient of Addison's disease include:[1]

Symptoms

Addison's disease often has an insidious onset. In many cases the disease is only recognized when the patient presents with an acute crisis precipitated by a stressful illness. Acute adrenal insufficiency should be considered in patients presenting with abdominal pain, nausea, diarrhea, hypotension and fever.[2][3]

Common Symptoms

Symptoms of Addisonian crisis

Symptoms of Addisonian crisis include:

References

  1. ↑ Quinkler M (2012). "[Addison's disease]". Med Klin Intensivmed Notfmed (in German). 107 (6): 454–9. doi:10.1007/s00063-012-0112-3. PMID 22907517.
  2. ↑ Sarkar SB, Sarkar S, Ghosh S, Bandyopadhyay S (2012). "Addison's disease". Contemp Clin Dent. 3 (4): 484–6. doi:10.4103/0976-237X.107450. PMC 3636818. PMID 23633816.
  3. ↑ Arlt W, Allolio B (2003). "Adrenal insufficiency". Lancet. 361 (9372): 1881–93. doi:10.1016/S0140-6736(03)13492-7. PMID 12788587.

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