Addison’s Disease
Abdullatiff Sami Al-Rashed
Block 2.3
College of Medicine, King Faisal University
Al-Ahsa, Saudi Arabia
Objectives
Definition
•Addison’s disease is an autoimmune
inflammation of adrenal glands, resulting in their
gradual destruction and inability to make
sufficient amounts of adrenal hormones.
•Life threatening emergency.
•No Cortisol & Aldosterone.
Anatomy
Etiology
Epidemiology
•The frequency rate of Addison's disease:
•Addison's can afflict persons of any age, gender, or
ethnicity, but it typically presents in adults between 30
and 50 years of age
Human Population1 in 10,000
Pathogenesis
•Addison’s disease occurs when more than 90%
of adrenal gland tissue is destroyed (primary
Addison’s disease).
•The destruction can occur due to various causes
that we discussed previously
Clinical Features
Clinical Features
Differential Diagnosis
The Case
•A 30 year old Caucasian women presents with
weakness and 4 kg weight loss in the past 3
months. Her friends are questioning why she has a
sun tan despite the winter season. Her medical
history is uneventful. Family history shows type 1
diabetes mellitus in a brother. On physical
examination her face, palmar creases and gingivae
appear to be hyper-pigmented. Sitting blood
pressure is 105 mm Hg systolic and 60 mm Hg
diastolic; supine blood pressure is 95 mm Hg
systolic and 55 mm Hg diastolic. Initial lab tests
demonstrate an elevated serum K+ and decreased
Na+ levels of 5.5 mmol/l and 132 mmol/l,
respectively
The Case
•A 30 year old Caucasian women presents with
weakness and 4 kg weight loss in the past 3
months. Her friends are questioning why she has a
sun tan despite the winter season. ?? Her medical
history is uneventful. Family history shows type 1
diabetes mellitus in a brother. On physical
examination her face, palmar creases and gingivae
appear to be hyper-pigmented. Sitting blood
pressure is 105 mm Hg systolic and 60 mm Hg
diastolic; supine blood pressure is 95 mm Hg
systolic and 55 mm Hg diastolic. Initial lab tests
demonstrate an elevated serum K+ and decreased
Na+ levels of 5.5 mmol/l and 132 mmol/l,
respectively