Addison's disease natural history, complications and prognosis: Difference between revisions

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{{Addison's disease}}
{{Addison's disease}}


{{CMG}}
{{CMG}} ; {{AE}} {{ADG}}
==Overview==
If left untreated, Addison's disease can be life-threatening. Complications of Addison's disease include [[hypoglycemia]], [[addisonian crisis]], [[hypoxia]], [[hypovolemic shock]], [[cardiac arrest]], [[stroke]]. Prognosis is generally good in patients with Addison's disease as long as they are on life time [[hormone replacement therapy]].


==Natural History==
==Natural History==
The symptoms of Addison's disease subside with treatment. Patients whose Addison's disease is due to treatable causes recover well once the cause is treated.  The rest of the patients require [[glucocorticoid]] and [[mineralocorticoid]] replacement for life.  Patients on steroid replacement therapy need to be closely monitored by an endocrinologist.
If left untreated, Addison's disease can be life-threatening. Any stressful event or illness can cause a sudden worsening of [[symptoms]], which can lead to severe [[dehydration]] and fatally low [[blood pressure]] and eventually death.


==Complications==
==Complications==
Complications of Addison's disease include;
Complications 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>
 
* [[Hypoglycemia]]
* [[Hypoglycemia]]
* [[Addisonian crisis]]
* [[Addisonian crisis]]
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==Prognosis==
==Prognosis==
While treatment solutions for Addison's disease are far from precise, overall long-term prognosis is typically good. Because of individual physiological differences, each person with Addison's must work closely with their physician to adjust their medication dosage and schedule to find the most effective routine. Once this is accomplished (and occasional adjustments must be made from time to time, especially during periods of travel, stress, or other medical conditions), symptomology is usually greatly reduced or occasionally eliminated so long as the person continues their dosage schedule.
*[[Prognosis]] is generally good in patients with Addison's disease as long as they are on life-time [[hormonal]] therapy.<ref name="pmid19011006">{{cite journal |vauthors=Erichsen MM, Løvås K, Fougner KJ, Svartberg J, Hauge ER, Bollerslev J, Berg JP, Mella B, Husebye ES |title=Normal overall mortality rate in Addison's disease, but young patients are at risk of premature death |journal=Eur. J. Endocrinol. |volume=160 |issue=2 |pages=233–7 |year=2009 |pmid=19011006 |doi=10.1530/EJE-08-0550 |url=}}</ref><ref name="pmid16968806">{{cite journal |vauthors=Bergthorsdottir R, Leonsson-Zachrisson M, Odén A, Johannsson G |title=Premature mortality in patients with Addison's disease: a population-based study |journal=J. Clin. Endocrinol. Metab. |volume=91 |issue=12 |pages=4849–53 |year=2006 |pmid=16968806 |doi=10.1210/jc.2006-0076 |url=}}</ref>
 
*Patients with Addison's disease must be closely monitored for [[Compliance (medicine)|compliance]] with medications as acute cases can be life-threating and the [[Mortality rate|mortality rates]] can go up to 95% in acute crisis.
If untreated Addison's disease can be fatal. Hormone pills should be taken for the rest of the patient's life.
 
As long as the proper dose of replacement medication is taken every day, an Addisonian can have a normal crisis-free life. There are no specific physical or occupational restrictions.
Routine care includes regular physician visits, avoidance of dehydration, and the use of extra medication during illness. [[Pregnancy]] is possible, but will require extra monitoring of the replacement medication.
Every Addisonian should wear an identification bracelet or preferably a necklace stating that he or she has the disease, in order to ensure proper emergency treatment. An identification card outlining treatment is also suggested.


==References==
==References==

Latest revision as of 16:46, 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

If left untreated, Addison's disease can be life-threatening. Complications of Addison's disease include hypoglycemia, addisonian crisis, hypoxia, hypovolemic shock, cardiac arrest, stroke. Prognosis is generally good in patients with Addison's disease as long as they are on life time hormone replacement therapy.

Natural History

If left untreated, Addison's disease can be life-threatening. Any stressful event or illness can cause a sudden worsening of symptoms, which can lead to severe dehydration and fatally low blood pressure and eventually death.

Complications

Complications of Addison's disease include:[1]

Prognosis

  • Prognosis is generally good in patients with Addison's disease as long as they are on life-time hormonal therapy.[2][3]
  • Patients with Addison's disease must be closely monitored for compliance with medications as acute cases can be life-threating and the mortality rates can go up to 95% in acute crisis.

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. Erichsen MM, Løvås K, Fougner KJ, Svartberg J, Hauge ER, Bollerslev J, Berg JP, Mella B, Husebye ES (2009). "Normal overall mortality rate in Addison's disease, but young patients are at risk of premature death". Eur. J. Endocrinol. 160 (2): 233–7. doi:10.1530/EJE-08-0550. PMID 19011006.
  3. Bergthorsdottir R, Leonsson-Zachrisson M, Odén A, Johannsson G (2006). "Premature mortality in patients with Addison's disease: a population-based study". J. Clin. Endocrinol. Metab. 91 (12): 4849–53. doi:10.1210/jc.2006-0076. PMID 16968806.

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