(Adrenal Insufficiency; Adrenocortical Hypofunction; Chronic Adrenocortical Insufficiency; Hypoadrenalism)
|Addison's occurs because of damage to the cortex.|
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- The body's own immune system attacking the gland. Known as an autoimmune disease. This cause accounts for 85% of cases in developed countries.
- Tuberculosis —major cause in the Third World countries
- Bleeding within the adrenal glands—related to use of anticoagulant medications and shock [extremely low blood pressure]
- Surgical complication
- Condition that are present at birth or due to genetic factors (enzyme defects, familial glucocorticoid insufficiency)
- Cytomegalovirus (CMV) infection associated with AIDS
- Fungal infections, including:
- Cancer including metastases from:
- Medications (such as ketoconazole or etomidate)
- Radiation treatment
- Chronic illness, including:
- Having the following autoimmune diseases:
- Anticoagulant medications
- Abdominal injury
- Family members with autoimmune-caused Addison's disease
Long-term steroid medication treatment, followed by:
- Severe stress
- Previous surgery on adrenal glands
- Extreme weakness, fatigue
- Weight loss
- Nausea or vomiting
- Chronic diarrhea
- Muscle weakness
- Darkening of freckles, nipples, scars, skin creases, gums, mouth, nail beds, and vaginal lining
- Emotional changes, especially depression
- Craving for salty foods
- Abdominal pain
- Severe abdominal, back, or leg pain
- Severe low blood pressure
- Severe dehydration
- Severe nausea, vomiting, and diarrhea
- Low blood sugar
- Generalized muscle weakness
Blood and urine tests—to see if you have low levels of cortisol and aldosterone, high level of adrenocorticotropic hormone (ACTH is a hormone that stimulates the adrenal glands), and to measure levels of:
- Blood urea nitrogen levels
- Anti-adrenal antibody (rarely done)
- ACTH stimulation test —measures cortisol in the blood before and after an injection of ACTH
- Self-injection of dexamethasone
- Hydrocortisone by IV
- Normal saline by IV
Addison's Disease.net http://www.addisonsdisease.net/
The Adrenoleukodystrophy Foundation http://www.aldfoundation.org/
National Adrenal Diseases Foundation http://www.nadf.us/
The Canadian Addison Society http://www.addisonsociety.ca/
Health Canada http://www.hc-sc.gc.ca/
Adrenocortical insufficiency. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated May 2, 2012. Accessed December 31, 2012.
Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health/endo/pubs/addison/addison.htm . Accessed December 31, 2012.
Arlt W, Allolio B. Adrenal insufficiency. Lancet . 2003;361(9372):1881-1893.
Dorin RI, Qualls CR, Crapo LM. Diagnosis of adrenal insufficiency. Ann Int Med . 2003;138:3:194-214.
Hahner S, Allolio B. Therapeutic management of adrenal insufficiency. Best Pract Res Clin Endocrinol Metab . 2009;23(2):167-79.
Salvatori R. Adrenal insufficiency. JAMA . 2005;294:2481-2488.
Ten S, New M, Maclaren N. Clinical Review 130: Addison's disease. J Clin Endo Metabol . 2001;86:2909-2922.
Thomas Z, Fraser GL. An update on the diagnosis of adrenal insufficiency and the use of corticotherapy in critical illness. Ann Pharmather . 2007;41:1456-65.
Wallace I, Cunningham S, Lindsay J. The diagnosis and investigation of adrenal insufficiency in adults. Ann Clin Biochem . 2009;46(Pt 5):351-367.
- Reviewer: Kim Carmichael, MD
- Review Date: 11/2012 -
- Update Date: 11/26/2012 -