Addison's disease history and symptoms

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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

History and Symptoms

Symptoms

The symptoms of adrenal insufficiency develop insidiousl. Some have marked cravings for salty foods due to the loss of sodium in the urine. Characteristics of the disease are:

Type of presentation Harmone deficiency Common symptoms Less common symptoms
Acute adrenal insufficiency Mainly cortisol In acute adrenal hemorrhage,
  • Deteriorates with sudden collapse,
  • Abdominal or flank pain,
  • Nausea with or without hyperpyrexia.
Chronic adrenal insufficiency Primary: Both glucocorticoid, mineralocorticoid
  • Hyperpigmentation (prominent on the sun-exposed areas of the skin, extensor surfaces, knuckles, elbows, knees)
  • Progressive weakness, fatigue, poor appetite, and weight loss.
  • Nausea, vomiting, and occasional diarrhea.
  • Muscle pains
  • Joint pains
Secondary: Glucorticoid


Symptoms Pathophysiology
Hyperpigmentation Stimulant effect of excess ACTH on the melanocytes to produce melanin
Dizziness with orthostasis
  • Volume depletion, loss of the mineralocorticoid effect of aldosterone,
  • Loss of the permissive effect of cortisol in enhancing the vasopressor effect of the catecholamines.
Myalgias and flaccid muscle paralysis Hyperkalemia
Amenorrhea Combined effect of weight loss and chronic ill health or secondary to premature autoimmune ovarian failure

References

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