What is Addison's disease?

This is not what I'm searching for. Written on 22-03-2011 by jahdegroot

Addison's disease is caused by a shortage of aldosterone and cortisol. The disease is very rare and therefore often diagnosed at a late stage; the prevalence of Addison's disease is only 120 in a million people. Anyone with Addison's disease can, in stressful times, suffer from an Addison's crisis and even go into (medical) shock. In some cases people die from Addison's disease.

What is Addison's disease?

Addison's disease is a disease caused by a shortage of aldosterone and cortisol. This shortage of aldosterone and cortisol is caused by a chronic primary adrenal cortex insufficiency. The disease was first described in 1855 by a doctor named Thomas Addison. The disease is therefore named after this doctor.

Because of the decreased functionality of the adrenal cortex (hypocortisolism) insufficient cortisol and aldosterone is produced. Aldosterone regulates the salt and water balance of the body and maintains blood pressure. Cortisol, however, plays an important role in the energy and bone metabolism and regulates neural and immunological processes.

In addition, the adrenal cortex influences all sort of functions of the human body during physical or mental activity. When exposed to stress, the adrenal glands in healthy individuals produce cortisol to enable the body to endure the stressful situation. In patients suffering from Addison's disease no extra cortisol will be produced during stress. During very stressful events, this can lead to an Addison's crisis and medical shock. In that case, immediate treatment by a doctor is required. If possible, patients should take their medicines on time to prevent an Addison's crisis and shock. So are you, for example, nervous for a visit to the dentist, take your medicines beforehand to prevent a crisis.

In the past, Addison's disease was often caused by tuberculosis (TBC). Nowadays, however, autoimmune diseases are the main cause of Addison's disease. 70 to 90 percent of all Addison's disease cases are caused by autoimmune diseases. Typical for Addison's disease is the orange/brown discoloration of the skin (hyperpigmentation) and the grey discoloration of the mucosa. The palms of the hands and the hand lines can also colour brown or orange. Hyperpigmentation is seen in 92% of all Addison's disease patients, and is therefore considered to be a symptom related to the disease. The hyperpigmentation is sometimes present even before other symptoms present themselves. When a patient with Addison's disease has no hyperpigmentation it can take very long to finally diagnose the disease, because all other symptoms are very aspecific.

Symptoms of Addison's disease

The symptoms of Addison's disease are in the following list. However, not every patient with Addison's disease will show all listed symptoms. Even if you suffer from a only few of the following symptoms you can have Addison's disease. If you doubt whether you suffer from Addison's disease, please consult your doctor for a physical examination.

Hyperpigmentation of the skin (orange/brown) or mucosa (grey)
Fatigue, weakness, apathy
Weight loss
Cravings for salty food
Increased fluid intake, but nevertheless signs of dehydration
Low blood pressure (hypotension)
Loss of appetite
Stomach ache
Hyperventilation
Prolonged nausea, sometimes accompanied by vomiting
Dizziness

Treatment of Addison's disease

Addison's disease is an incurable disease, but the patient can be treated. Usually, the patient is treated with oral corticosteroids. The corticosteroids relieve the shortage of glucocorticoids and mineralocorticoids in the body. When the medicines are administered correctly, the patients' symptoms will generally disappear. When the patient has a high fever, the dose of the medicine should be three times higher than the dose that is normally prescribed. If the patient has to undergo surgery the patient will generally receive an intravenous infusion of 100mg/m2 of hydrocortisones for 24 hours before and after surgery.