Addison’s disease

Mar 18, 2012 , Ondřej Volný

addisonuv-syndrom.jpg - kopie
addisonuv-syndrom.jpg - kopie
Addison's disease or hypocortisolism is a disease caused by adrenal insufficiency. Typical is increased pigmentation of the skin and mucous membranes. Pigmentation similar to graphite spots appear in places exposed to pressure, skin folds, then in nail beds, mammary areolae and the mucosa in the oral cavity.

Addison's disease

The cause of Addison's disease is a bilateral adrenal dysfunction. The adrenal glands do not produce enough hormones, namely aldosterone, cortisol and sex hormones. This condition can be understood as a failure of adrenal glands. The following paragraphs briefly describe the adrenal glands and their hormones. Further, we describe symptoms, causes, diagnosis and treatment of Addison's disease.

Adrenal gland

The adrenal gland is a pair organ located in close proximity to the kidney, it is triangular and its size is 5 x 1.5 x 0.5 cm. Anatomically speaking it lies near the spine, at the level of the 11th rib. It consists of two functionally distinct parts, the cortex and medulla. Both cortex and medulla produce important hormones. The adrenal gland is an essential organ involved in a complex system of hormonal regulation of our body. You can imagine the mediators, i.e. hormones, as letters, which distant organs use to communicate with each other. These "letters" are sent to the organs by blood. This ingenious system of our body guarantees that everything works as it should, that the "letter" - a hormone gets to the correct address and informs the correct addressee. Each organ has its exact location and a different "mailbox", where only the letters of the "right" size and shape fit. This ensures that the letter is received "in to good hands" - to the correct organ.

Causes of Addison's disease

The adrenal cortex is hormonally controlled exclusively by the pituitary gland, it hangs, as the name suggests, on the basis of the brain. In the control of the cortex are also involved the kidneys, which affect production of aldosterone. The medulla is independent of the pituitary gland and mainly produces well-known adrenaline in response to various stress situations. Adrenal cortex produces steroid hormones, or steroids. Among the steroids belongs aldosterone, which affects the management of minerals, particularly sodium and potassium. Another hormone cortisol affects the metabolism of carbohydrates, less fat and proteins. In the case of its insufficient production, this causes the so-called Addison's disease. The adrenal cortex also produces sex hormones, both male and female. For Addison's disease, we distinguish a primary and a secondary disease. The primary disease is caused by adrenal insufficiency; the secondary disease is caused by pituitary gland disorder, which directs everything.

Frequently asked questions for Addison's disease

What is the cause of Addison's disease?

Bilateral damage to the adrenal glands. Addison's disease is referred to as hypocorticism, or reduced or missing function of the adrenal cortex.

Which hormones are insufficiently produced?

Aldosterone, cortisol and sex hormones.

What can cause bilateral adrenal failure in Addison's disease?

Insufficient blood supply, especially after shock - similar to a heart attack. Furthermore, autoimmune disease, which is damage caused by its own immune cells (adrenal glands are mistaken for a foreign object and are attacked by its own immune system). Adrenal failure may also be caused by their bleeding. Another cause is infection - particularly dangerous are meningococcal infections in children, therefore vaccination is recommended and then for adults adrenal tuberculosis. Also a genetic defect of the enzyme that ensures the production of adrenal hormones can cause bilateral kidney failure. Furthermore, rare diseases, such as sarcoidosis.

What are the symptoms of a lack of a mineralocorticoid aldosterone?

The prefix mineral - affects mineral management, particularly sodium and potassium, has an effect on blood pressure, renal blood flow and the management of body water (holds water) and the above mentioned minerals. Deficiency leads to excessive loss of water (dehydration), decrease of blood pressure and loss of consciousness appear (especially when standing up quickly from a lying or sitting position). Levels of potassium increase, which at higher levels has a negative effect on the heart.

What are the symptoms of a lack of a glucocorticoid cortisol?

It is essential for carbohydrate metabolism and its deficiency leads to hypoglycemia (low sugar levels), which is reflected by feelings of fatigue, lack of energy, confusion, impaired consciousness. Severe low blood sugar can lead to coma and even death. Lack of cortisol reduces the individual's ability to cope with stressful situations. People suffering from lack of cortisol find it difficult to manage stress!! Lack of cortisol also leads to a drop in blood pressure and collapses, reduces appetite, often with nausea, vomiting and weight loss. There is also difficulty concentrating, irritability, worrying, and mood instability.

What are the symptoms of a lack of sex hormones?

The absence typically affects only women. Adrenal glands are the only organ of the female body that produce male sex hormones, or androgens, from them especially testosterone. They are essential for a women's proper sexual development. Testosterone deficiency affects the female by loss of pubic hair and decrease in the sexual appetite called libido.

Other typical symptoms of Addison's disease

Addison's disease is characterized by increased pigmentation of the skin and mucous membranes. It is similar to graphite pigmentation spots in places exposed to pressure, skin folds, nail beds, mammary areolae and the mucosa in the oral cavity (typically in areas where the mucosa is pressed by teeth or dentures).

Diagnosis and treatment of Addison's disease

If you have the above mentioned symptoms immediately consult your general physician or a specialist endocrinologist doctor. Addison's disease can be diagnosed by blood analysis and using ultrasound or other imaging methods. Treatment is necessary, adrenal glands are essential organs. Survival with nonfunctional adrenal glands without treatment is not possible. Treatment of Addison's disease must be individual, the aim is the administration of synthetic hormones that replace the missing production, and thus replace malfunctioning adrenal glands. Treatment must be followed by a specialist in endocrinology, which is a branch of internal medicine dealing with disorders of the endocrine glands.

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