ADDISON'S DISEASE a.k.a. - Adrenocortical Hypofunction, Chronic Hypoadrenocorticism

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ADDISON'S DISEASE: Addison's Disease results from a deficiency in the secretion of adreno-corticol hormones. This is a long-term underfunction of the outer portion of the adrenal gland. The adrenal glands are tiny glands that sit on top of each kidney and look like little party hats. It is described as chronic insufficiency of the adrenal cortex.

Symptoms: There is an increased pigmentation of the skin (bronzing) and mucous membranes with irregular patches of vitiligo. There may be black freckles over the head and neck. Also weakness, fatigue, hypotension, nausea, vomiting, anorexia, weight loss and sometimes hypoglycemia.

Etiology: This may be due to a number of different insults to the adrenal including physical trauma, hemorrhage, and tuberculosis of the adrenal, and destruction of the cells in the pituitary gland that secrete ACTH (adrenocorticotropic hormone) which normally drives the adrenal glands. The progression is destructive to the adrenal glands whether from infectious disease or an infiltration of neoplastic tissues [abnormal growth of tissue; tumor) or hemorrhage into the gland.

Treatment: Adrenocortical hormone therapy is dramatic in its effect and must be given promptly in an adreanl crisis in order to prevent death. If untreated, the disease will continue a chronic course with progressive and slow deterioration. Some patients with deterioration may experience this progression more rapidly.

History: Named after the British physician Thomas Addison (1793-1860). U.S. President J.F. Kennedy is said to have had Addison disease. When Addison first identified adrenal insufficiency in 1849, Tuberculosis (TB) was responsible for 70 - 90% of the cases. As the treatment for TB improved, the incidence of adrenal insufficiency due to TB of the adrenal glands greatly reduced. TB now accounts for around 20% of cases of primary adrenal insufficiency in developed countries.

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