Alternative Names primary adrenocortical insufficiency, primary adrenal failure
Definition Addison's disease occurs when the adrenal glands in the body are destroyed and no longer able to produce certain hormones needed for life.
What is going on in the body? There are two adrenal glands in the body, one on top of each kidney. The outer portion of the adrenal glands secretes two main hormones. These hormones are important for the body's salt balance and metabolism. Without one of these hormones, called cortisol, a person cannot live. Certain conditions, such as infections and cancer, can cause destruction of both glands, leaving the body without the vital hormones the adrenal glands produce.
What are the signs and symptoms of the disease? In most cases, the symptoms of Addison's disease come on gradually. Addison's disease commonly causes these symptoms:
What are the causes and risks of the disease? This condition is fairly rare but can be caused by:
an autoimmune disorder, in which the person's own immune system attacks and destroys the adrenal glands. This is by far the most common cause of Addison's disease, but the reason for the disorder is unknown.
certain medications, such as ketoconazole, which is used to treat fungal infections
There are other causes of low adrenal hormones, which are not considered Addison's disease. For example, some people must take an adrenal hormone, known as corticosteroid, or steroids for short, for short periods to treat certain medical problems. Adrenal hormone levels can fall when the person is taken off the medication. This is actually a very common cause of low adrenal hormone, but it is not called Addison's disease.
The most feared risk from Addison's disease is Shock leading to death. This can easily be avoided with proper treatment.
What can be done to prevent the disease? Usually, nothing can be done to avoid Addison's disease. People with certain infections, such as tuberculosis, can sometimes avoid this condition if their infections are treated early.
How is the disease diagnosed? The symptoms and physical examination usually make a doctor suspicious. Blood tests can confirm the low adrenal hormone and its effects on the body. Further tests, such as special x-ray tests, may be needed to determine the cause of Addison's disease.
What are the long-term effects of the disease? shock and death can result if the condition is not treated. With treatment, there are generally no long-term effects. In life-threatening situations and illnesses, a person may need increased doses of hormones given as pills or injections to survive.
What are the risks to others? Others are usually not at risk. In rare cases, a person with Addison's disease may have an infection that can be contagious.
What are the treatments for the disease? Treatment involves replacing the missing adrenal hormones. Initial therapy may include IV fluids, other medications to support blood pressure or treat infections, and IV hormones. Once a person is stable, hormone pills alone can be used.
What are the side effects of the treatments? Initial treatment may involve the use of medications to support blood pressure or treat infections. These medications may cause side effects, such as allergic reactions and stomach upset. If hormones are given in too low or too high an amount, uncomfortable symptoms can result. For example, if adrenal hormone levels are too high, people can get mood swings and body swelling.
What happens after treatment for the disease? Generally, lifelong hormone replacement is required. This is because the adrenal glands are destroyed and unable to recover.
How is the disease monitored? Blood tests can be used to check for salt balance and hormone levels.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
