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Addison's disease
Posted Tue, 30 May 2000
Question
What is Addison's disease?
Answer
This is a disease of the adrenal glands, which sit on top of the kidneys, which produce mainly the hormones associated with salt and water balance in the body.
About 70% of cases have an autoimmune cause. The rest are caused by destruction of the gland by disease such as TB and cancers. The incidence of the disease is around 4 per 100,000, occurs equally in each sex, and tends to become apparent during metabolic stress and trauma.
Symptoms are weakness, tiredness and blood pressure falling when rising suddenly from a sitting or lying position (orthostatic hypotension). There is also widespread tanning of both sun exposed and other parts of the body, and most characteristically, of the mucous membranes inside the mouth.
In the later stages of the disease weight loss, dehydration, low blood pressure and a small heart are characteristic. This is often coupled with loss of appetite, vomiting and diarrhoea. There may also be decreased tolerance of cold, with dizziness and fainting spells.
The disease has a gradual onset and the early symptoms are non-specific making diagnosis difficult.
Once the disease is suspected then blood tests will reveal characteristic changes in certain hormone levels and in the levels of sodium in the body.
Treatment is by replacement of the missing steroid hormones. Addison's disease, even when treated, can lead to problems in any type of trauma, if someone needs an anaesthetic, or in the case of severe infection. So, anyone with this should wear a Medic-Alert bracelet warning of their condition.
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