Definition

Addison's disease is a rare disorder of the adrenal glands. With Addison's, the adrenal glands do not produce enough of the hormones cortisol and aldosterone.

Adrenal Glands Addison's occurs because of damage to the cortex. Copyright © Nucleus Medical Media, Inc.

Causes    TOP

Addison's disease is the result of gradual damage to the outer layer of the adrenal gland. This damage may be caused by:

• An autoimmune reaction—the body's own immune system attacks the gland
• Tuberculosis
• Bleeding within the adrenal glands—related to the use of anticoagulant medications and shock
• A surgical complication
• Conditions that are present at birth or due to genetic factors such as enzyme defects and familial glucocorticoid insufficiency
• Cytomegalovirus (CMV) infection associated with AIDS
• Fungal infections
• Certain cancers, including those that have spread
• Certain medications
• Radiation therapy
• Chronic disorders, such as:
  • Sarcoidosis
  • Hemochromatosis
  • Amyloidosis
  • Adrenoleukodystrophy
  • Adrenomyelodystrophy

Risk Factors    TOP

Factors that may increase your chance Addison's disease include:

• Autoimmune disorders, such as:
  • Type I diabetes
  • Pernicious anemia
  • Hypoparathyroidism
  • Hypopituitarism
  • Hyperthyroidism or hypothyroidism
  • Myasthenia gravis
• Stress
• Anticoagulant medications
• Abdominal injury
• Family members with autoimmune-caused Addison's disease
• Long-term steroid medication treatment, followed by:
  • Severe stress
  • Infection
  • Surgery
  • Trauma
• Previous surgery on adrenal glands
• Hereditary disorders, such as Prader-Willi syndrome and congenital adrenal hyperplasia

Symptoms    TOP

Symptoms may include:

• Extreme weakness, fatigue
• Weight loss
• Nausea or vomiting
• Chronic diarrhea
• Muscle weakness or pain
• Darkening of freckles, nipples, scars, skin creases, gums, mouth, nail beds, and vaginal lining
• Emotional changes, especially depression
• Cognitive impairment or confusion
• Craving salty foods
• Abdominal pain
• Lack of appetite
• Amenorrhea

A severe complication of Addison's disease is the Addisonian or adrenal crisis. Adrenal crisis is a life threatening disorder, its symptoms include:

• High or low body temperature
• Severe abdominal, back, or leg pain
• Fainting
• Severe dehydration
• Severe nausea, vomiting, and diarrhea
• Bluish skin color
• Muscle weakness

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

• Blood tests
• Urine tests
• ACTH stimulation test

Imaging tests evaluate the adrenal glands and surrounding structures. These may include:

• MRI scan
• CT scan

Treatment    TOP

Symptoms of Addison's disease can be controlled with medications. They replace the missing hormones. Medication needs to be taken for the rest of your life. They may need to be increased during times of stress.

Immediate treatment of adrenal crisis includes:

• Self-injection of dexamethasone
• Hydrocortisone by IV
• Normal saline by IV

Surgery may also be needed for adrenal tumors or pituitary tumors causing the disease.

Prevention    TOP

There are no current guidelines to prevent Addison's disease.