Addison's disease - Revision history

Rossdonaldson1: /* Background */

2024-02-14T16:40:30Z

Background

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	==Background==		==Background==
			[[File:Gray1120-adrenal glands.png\|thumb\|Posterior view of the adrenal glands (colored) in relation to the viscera and large vessels of the abdomen (thoracic vertebra removed).]]
			[[File:HPA axis combined.jpg\|thumb\|Types of adrenal insufficiency (primary, secondary, and tertiary) compared to normal physiology. In its normal state, the hypothalamus secretes corticotropin-releasing hormone (CRH) to induce the pituitary gland to secrete adrenocorticotropic hormone (ACTH) to induce the adrenal gland to secrete cortisol. Cortisol then exerts negative feedback by inhibiting the secretion of CRH and ACTH in the hypothalamus and pituitary gland, respectively.]]
	*Primary [[adrenal insufficiency]]		*Primary [[adrenal insufficiency]]
	*Autoimmune disease (70-90%)		*Autoimmune disease (70-90%)

Rossdonaldson1: /* Differential Diagnosis */

2024-02-14T16:38:57Z

Differential Diagnosis

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	*Secondary adrenal insufficiency - deficiency of ACTH (produced by the pituitary gland)		*Secondary adrenal insufficiency - deficiency of ACTH (produced by the pituitary gland)
	*Tertiary adrenal insufficiency - deficiency of CRH (produced by the hypothalamus)		*Tertiary adrenal insufficiency - deficiency of CRH (produced by the hypothalamus)

			{{Adrenal crisis ddx}}

	==Evaluation==		==Evaluation==

Kfarzam: /* Management */

2022-08-20T05:54:10Z

Management

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	*Hormone Replacement<ref>de Herder WW, van der Lely AJ (May 2003). "Addisonian crisis and relative adrenal failure". Reviews in Endocrine and Metabolic Disorders 4 (2): 143–7.</ref>		*Hormone Replacement<ref>de Herder WW, van der Lely AJ (May 2003). "Addisonian crisis and relative adrenal failure". Reviews in Endocrine and Metabolic Disorders 4 (2): 143–7.</ref>
	**PO [[hydrocortisone]] and [[fludrocortisone]]		**PO [[hydrocortisone]] and [[fludrocortisone]]
			*Adrenal crisis should be treated with 100mg hydrocortisone IV followed by 50mg IV q6 hours

	==Disposition==		==Disposition==

Josgood: /* Clinical Features */

2021-01-06T06:38:50Z

Clinical Features

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	*[[Abdominal pain]]		*[[Abdominal pain]]
	**Chronic [[nausea]], [[vomiting]], [[diarrhea]]		**Chronic [[nausea]], [[vomiting]], [[diarrhea]]
	*[[Weakness[[ and fatigue		*[[Weakness]] and fatigue
	*Salt craving		*Salt craving
	*Abnormal skin pigmentation - will often look patchy		*Abnormal skin pigmentation - will often look patchy

ClaireLewis at 15:12, 28 September 2019

2019-09-28T15:12:42Z

← Revisión anterior		Revisión del 15:12 28 sep 2019
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	==Background==		==Background==
	*Primary adrenal insufficiency		*Primary [[adrenal insufficiency]]
	*Autoimmune disease (70-90%)		*Autoimmune disease (70-90%)
	**Tuberculosis previously most common cause		**[[Tuberculosis]] previously most common cause
	**Other causes include infectious, metastatic cancer, lymphoma, adrenal hemorrhage, infarction, drugs		**Other causes include infectious, metastatic cancer, [[lymphoma]], adrenal hemorrhage, infarction, drugs
	*Typically presents in adults between 30 and 50 years of age		*Typically presents in adults between 30 and 50 years of age
	**All ages, races, genders can be affected		**All ages, races, genders can be affected
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	*[[Abdominal pain]]		*[[Abdominal pain]]
	**Chronic [[nausea]], [[vomiting]], [[diarrhea]]		**Chronic [[nausea]], [[vomiting]], [[diarrhea]]
	*Weakness and fatigue		*[[Weakness[[ and fatigue
	*Salt craving		*Salt craving
	*Abnormal skin pigmentation - will often look patchy		*Abnormal skin pigmentation - will often look patchy
	*Addisonian ~~Crisis~~		*Addisonian crisis:
	**Hypotension		**[[Hypotension]]
	**Neurologic ~~Symptoms~~: coma		**Neurologic symptoms: [[coma]]

	==Differential Diagnosis==		==Differential Diagnosis==
	*Corticosteroid withdrawal		*[[Corticosteroid]] withdrawal
	*Secondary adrenal insufficiency - deficiency of ACTH (produced by the pituitary gland)		*Secondary adrenal insufficiency - deficiency of ACTH (produced by the pituitary gland)
	*Tertiary adrenal insufficiency - deficiency of CRH (produced by the hypothalamus)		*Tertiary adrenal insufficiency - deficiency of CRH (produced by the hypothalamus)
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	==Disposition==		==Disposition==
	*New ~~Diagnosis~~: strong consideration for admission		*New diagnosis: strong consideration for admission
	*Crisis?: Consider admission based on electrolytes and clinical presentation		*[[adrenal crisis\|Crisis]]?: Consider admission based on electrolytes and clinical presentation

	==See Also==		==See Also==

Rossdonaldson1: /* Clinical Features */

2019-03-06T07:17:24Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
			[[File:WomenWithAddison.jpg\|thumb\|A Caucasian woman with Addison's disease]]
	*[[Abdominal pain]]		*[[Abdominal pain]]
	**Chronic [[nausea]], [[vomiting]], [[diarrhea]]		**Chronic [[nausea]], [[vomiting]], [[diarrhea]]

Sabedi: /* Background */

2018-10-22T02:36:14Z

Background

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	==Background==		==Background==
	~~{{Addison's background}}~~		*Primary adrenal insufficiency
			*Autoimmune disease (70-90%)
			**Tuberculosis previously most common cause
			**Other causes include infectious, metastatic cancer, lymphoma, adrenal hemorrhage, infarction, drugs
	*Typically presents in adults between 30 and 50 years of age		*Typically presents in adults between 30 and 50 years of age
	**All ages, races, genders can be affected		**All ages, races, genders can be affected
	*Higher incidence with other autoimmune deficiencies		*Higher incidence with other autoimmune deficiencies

	==Clinical Features==		==Clinical Features==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-26T12:08:27Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

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	*Tertiary adrenal insufficiency - deficiency of CRH (produced by the hypothalamus)		*Tertiary adrenal insufficiency - deficiency of CRH (produced by the hypothalamus)

	==~~Diagnosis~~==		==Evaluation==
	===Laboratory findings===		===Laboratory findings===
	*[[Hypercalcemia]]		*[[Hypercalcemia]]
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	**Low stimulation of the renal distal tubule by aldosterone = sodium wasting in the urine and H+ retention		**Low stimulation of the renal distal tubule by aldosterone = sodium wasting in the urine and H+ retention

	===~~Diagnosis~~===		===Evaluation===
	*Chemistry		*Chemistry
	*Random cortisol, renin, and ACTH levels		*Random cortisol, renin, and ACTH levels

Ostermayer: Text replacement - "Category:Endo" to "Category:Endocrinology"

2016-03-22T14:01:01Z

Text replacement - "Category:Endo" to "Category:Endocrinology"

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	<references/>		<references/>

	[[Category:~~Endo~~]]		[[Category:Endocrinology]]

Rossdonaldson1 at 15:49, 28 July 2015

2015-07-28T15:49:15Z

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	*Higher incidence with other autoimmune deficiencies		*Higher incidence with other autoimmune deficiencies

	==Clinical ~~Presentation~~==		==Clinical Features==
	*Abdominal pain		*[[Abdominal pain]]
	**Chronic nausea, vomiting, diarrhea		**Chronic [[nausea]], [[vomiting]], [[diarrhea]]
	*Weakness and fatigue		*Weakness and fatigue
	*Salt craving		*Salt craving
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	**Low stimulation of the renal distal tubule by aldosterone = sodium wasting in the urine and H+ retention		**Low stimulation of the renal distal tubule by aldosterone = sodium wasting in the urine and H+ retention

	===~~Workup~~===		===Diagnosis===
	*Chemistry		*Chemistry
	*Random cortisol, renin, and ACTH levels		*Random cortisol, renin, and ACTH levels