QS Study

Hypoadrenalism or Addison’s disease

This is a clinical condition caused by the hypofunctional state of the adrenal cortex. It is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. It is a disorder that occurs when your body produces inadequate amounts of certain hormones produced by your adrenal glands.

Cause: It is caused by disruptions to the adrenal glands, preventing normal secretions of corticosteroids.

  1. Tuberculosis destruction of the adrenal gland.
  2. Autoimmune inflammation of the adrenal gland.
  3. Invasion of adrenal cortices by cancer.

Clinical Features:

Glucocorticoid insufficiency:

  • Weight loss,
  • Malaise,
  • Weakness,
  • Anorexia,
  • Nausea,
  • Vomiting,
  • G1T – Diarrhea or constipation,
  • Postural hypotension,
  • Hypoglycemia.

Mineralocorticoid insufficiency

  • Hypotension (↓BP).

Increase ACTH secretion:

  • Pigmentation,
  • Sun-exposed areas,
  • Pressure areas (e.g., Elbows, knees, Palmar crease, knuckles, Mucous membrane, Conjunctivitis.)

Loss of adrenal androgen: Decrease in body hair esp. in the female.

Treatment: It is treated with medication to replace the missing hormones. Daily administration of small quantities of mineralocorticoids and glucocorticoids.

Addisonian crisis

Patients with Addison’s disease at the time of stress develop severe hypotension and shock. This known as the Addisonian crisis. If you have untreated Addison’s disease, an Addisonian crisis may be aggravated by physical stress, such as an injury, infection or illness.