Causes and Symptoms (Magill’s Medical Guide, Sixth Edition)
Anything that results in damage to the adrenal gland has the potential to cause the development of Addison’s disease. Most commonly, the disorder is the result of an autoimmune malfunction, in which the body begins to react against its own tissue. The disorder may also result from adrenal cancers or infections. The prevalence rate is approximately 1 per 100,000 people.
The specific cause of the adrenal insufficiency may be either primary or secondary. In the case of primary adrenal insufficiency, the disorder arises directly within the outer region of the adrenal gland, called the adrenal cortex. Most of the time, the disorder is associated with an autoimmune dysfunction in which the body produces antibodies against adrenal tissue. Over time, the adrenal cortex is destroyed and the secretion of glucorticoid, mineralocorticoid, and adrenogenic hormones, the products of the adrenal cortex, ceases. Another cause of primary adrenal insufficiency is bacterial infections, particularly those associated with tuberculosis. The first identification of the disease, described by Thomas Addison in 1855, was associated with a tuberculosis infection in his patient. Other less common causes include fungal infections and malignancies.
Secondary adrenal insufficiency does not originate with the adrenal glands but rather is associated with abnormal regulation of adrenal hormone production, a function of the pituitary gland. Among...
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Treatment and Therapy (Magill’s Medical Guide, Sixth Edition)
The treatment of Addison’s disease generally involves replacing the hormones that the adrenal cortex is no longer manufacturing. Oral medication is available for most of these hormones, though dietary changes may also be necessary. For example, if the mineralocorticoid aldosterone is insufficient, resulting in a salt imbalance, then patients taking aldosterone supplements may also be advised to increase the salt content of their food.
Other forms of treatment may be symptomatic. If the patient suffers from low blood pressure or severe salt imbalances, conditions that are potentially life-threatening, then intravenous medication may be necessary.
As the monitoring of potassium and sodium levels is critical, it is generally recommended that patients routinely visit their physicians. It is important that a patient exhibiting symptoms of an Addisonian crisis (vomiting, diarrhea) receive immediate salt replacement and probably hydrocortisone as well.
Because secondary adrenal deficiency most often originates in the pituitary gland, the primary result is a decrease in ACTH production. In turn, the adrenal cortex is deficient only in the production of cortisol. Treatment generally involves the oral replacement of cortisol, often in the form of synthetic prednisone.
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
Addison’s disease is a lifelong, chronic condition. While in the past it was often a life-threatening disorder, proper monitoring and hormone replacement can allow most people with the disease to live relatively normal lives with no restrictions. Because in most individuals the immediate cause is an autoimmune disorder, it is possible that eventually stem cell research, along with improved methods of controlling autoimmune phenomena, will provide a means for replacing adrenal tissue.
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Bar, Robert, ed. Early Diagnosis and Treatment of Endocrine Disorders. Totowa, N.J.: Humana Press, 2003.
Besser, G. Michael, and Michael Thorner, eds. Clinical Endocrinology. 2d ed. St. Louis, Mo.: Gower-Mosby, 1994.
Greenspan, Francis S., Dolores M. Shoback, and David G. Gardner, eds. Greenspan’s Basic and Clinical Endocrinology. 8th ed. New York: McGraw-Hill, 2007.
Kronenberg, Henry M., et al., eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia: Saunders/Elsevier, 2008.
Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Addison’s Disease. San Diego, Calif.: Icon Health, 2002.
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Addison's Disease (Encyclopedia of Medicine)
Addison's disease is a disorder involving disrupted functioning of the part of the adrenal gland called the cortex. This results in decreased production of two important chemicals (hormones) normally released by the adrenal cortex: cortisol and aldosterone.
The adrenals are two glands, each perched on the upper part of the two kidneys. The outer part of the gland is known as the cortex; the inner part is known as the medulla. Each of these parts of the adrenal gland is responsible for producing different types of hormones.
Cortisol is a very potent hormone produced by the adrenal cortex. It is involved in regulating the functioning of nearly every type of organ and tissue throughout the body, and is considered to be one of the few hormones absolutely necessary for life. Cortisol is involved in:
- the very complex processing and utilization of many nutrients, including sugars (carbohydrates), fats, and proteins
- the normal functioning of the circulatory system and the heart
- the functioning of muscles
- normal kidney function
- production of blood cells
- the normal processes involved in maintaining the skeletal system
- proper functioning of the...
(The entire section is 1163 words.)