Understanding Glucocorticoid deficiency: Causes, Symptoms, and Management

What is it?

Addison’s disease, or primary adrenal insufficiency occurs when the adrenal gland is damaged and does not produce enough cortisol or aldosterone. It is more common in women and in the ages between 30-50. It is usually the result of an autoimmune attack on the adrenal cortex. Other etiologies may include injury to the adrenal gland, infection such as tuberculosis, metastases to the adrenal gland, bleeding into the adrenal gland, surgical removal of the gland, amyloidosis and some genetic conditions.

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Additional names

This group contains additional names:
- ACTH deficiency
- Acyl-CoA oxidase deficiency
- Addisonian crisis
- Adrenal atrophy
- Adrenal calcification
- Adrenal cortical hypofunction
- Adrenal gland hematoma
- Adrenal hemorrhage
- Adrenal insufficiency
- Hypoadrenalism
- Secondary adrenal insufficiency
- Addison’s disease
- Secondary hypocortisolism

Signs & symptoms

Early stage symptoms are not specific and may include fatigue, abdominal pain, dehydration, muscle weakness, loss of appetite, weight loss and increased thirst. Over time they may become more severe and include dizziness, fainting, cramps, exhaustion, low blood glucose, low blood pressure, sensitivity to cold, and hyperpigmented areas. If symptoms are acute, a medical emergency called Addisonian crisis may occur. Addisonian crisis may include confusal, mental changes, dehydration, weakness, high fever, lightheadedness, vomiting and diarrhea.

Diagnosis

Addison’s disease is diagnosed by physical examination for hyperpigmented patches on the skin, blood test for levels of sodium, potassium, cortisol and ACTH. An ACTH stimulation test might be performed- a shot of artificial ACTH is given to test levels of cortisol production. If cortisol levels are low- adrenal glands might not work properly. XRAY may show calcium deposits in the adrenal glands,CT scan may also be performed.

Treatment

Treatment may include hydrocortisone and fludrocortisone acetate to replace cortisol and aldosterone levels.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital