Addison’s disease is an autoimmune disease, expressed as a failure by the adrenal glands to release the hormone cortisol.
Adrenal insufficiency may be due to various causes. Primary adrenal insufficiency – a lack of response to ACTH hormone, secreted by the pituitary gland to stimulate the release of cortisol. Secondary failure – this is a problem in the pituitary gland, which secretes the hormone is not enough to stimulate the secretion of ACTH and cortisol. This can lead to atrophy of the gland in the absence of the need for it. Signs of primary failure can be seen in changes in the indices of a blood test – the level of electrolytes (potassium\sodium). Secondary adrenal insufficiency difficult to diagnose.
Addison’s disease is a primary failure, as well as the most severe form. In this case, the adrenal glands atrophy, being attacked by antibodies the body’s own (That’s an autoimmune disease).
We select the narrow section expert for treatment of each type of the disease, which makes treatment more efficient. Our experienced specialist make an accurate diagnosis on the basis of which will be matched by appropriate treatment.
The reasons for the lack of activity of the adrenal glands: Infectious diseases – tuberculosis, CMV and histoplasmosis, cardiovascular diseases, diseases in which substances accumulate in the body – adrenoleukodystrophy, a genetic disorder in which the long-chain fatty acids accumulate in the adrenal glands, hemochromatosis, amyloidosis, sarcoidosis, a disease resulting from the treatment of, for example, long-term steroid therapy.
Symptoms: vomiting, weakness and fatigue, loss of appetite, low blood pressure, nausea and vomiting.
The bark of the right adrenal distinguishes three types of hormones, including cortisol and aldosterone. Absence or lack of cortisol and aldosterone, is responsible for the manifestation of the disease.
Cortisone is a hormone that helps the body deal with stress by increasing blood pressure, increased sugar in the body, etc. Manifestations of the disease associated with deficiency of cortisone: hyperpigmentation of the skin, mucous membrane, nipples, open areas, folds and scars, low blood pressure, loss of appetite, nausea and vomiting and weight loss, hypoglycemia, fatigue, confusion, and psychotic behavior, inability to cope with stressful situations increasing the number of white blood cells in the blood.
With a deficit of aldosterone (its main function is to regulate blood pressure) low sodium levels (hyponatremia), high potassium levels (hyperkalemia) can lead to irregular heartbeat.
Diagnosis of Addison’s disease
Test reaction to ACTH – good condition increases the secretion of adrenal cortisol response to ACTH stimulation. Lack of response indicates adrenal insufficiency. The test includes two analyzes of blood, in which the addresses of ACTH and cortisol levels before and one hour after the injection of ACTH. Normally, cortisol levels should be not less than 20 micrograms per deciliter.
In the diagnosis may also need chest X-ray.
Management
As with any hormonal deficiency, treatment is carried out by filling the missing hormone, cortisol. The patient may be prescribed drugs containing natural hormone cortisol and synthetic hormones.
Complications
Addison’s crisis – a life-threatening condition that occurs due to a serious lack of cortisol and aldosterone. Clinical signs include fever, vomiting, abdominal pain, change in pattern recognition.
Treatment crisis requiring immediate administration of cortisol for 5-10 minutes, and then 300 mg over the next 24 hours. Furthermore, the patient must be fluid to the balance and aldosterone blood pressure.
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