Addison’s DiseaseAbdullatiff Sami Al-RashedBlock 2.3College of Medicine, King Faisal University Al-Ahsa, Saudi Arabia

Objectives

Definition

• Addison’s disease is an autoimmune inflammation of adrenal glands, resulting in their gradual destruction and inability to make sufficient amounts of adrenal hormones.

• Life threatening emergency.

• No Cortisol & Aldosterone.

Anatomy

Etiology

Epidemiology

• The frequency rate of Addison's disease:

• Addison's can afflict persons of any age, gender, or

ethnicity, but it typically presents in adults between 30

and 50 years of age

Human Population 1 in 10,000

Pathogenesis

• Addison’s disease occurs when more than 90% of adrenal gland tissue is destroyed (primary Addison’s disease).

• The destruction can occur due to various causes that we discussed previously

Clinical Features

Clinical Features

Differential Diagnosis

The Case• A 30 year old Caucasian women presents with

weakness and 4 kg weight loss in the past 3 months. Her friends are questioning why she has a sun tan despite the winter season. Her medical history is uneventful. Family history shows type 1 diabetes mellitus in a brother. On physical examination her face, palmar creases and gingivae appear to be hyper-pigmented. Sitting blood pressure is 105 mm Hg systolic and 60 mm Hg diastolic; supine blood pressure is 95 mm Hg systolic and 55 mm Hg diastolic. Initial lab tests demonstrate an elevated serum K+ and decreased Na+ levels of 5.5 mmol/l and 132 mmol/l, respectively

The Case• A 30 year old Caucasian women presents with

weakness and 4 kg weight loss in the past 3 months. Her friends are questioning why she has a sun tan despite the winter season. ?? Her medical history is uneventful. Family history shows type 1 diabetes mellitus in a brother. On physical examination her face, palmar creases and gingivae appear to be hyper-pigmented. Sitting blood pressure is 105 mm Hg systolic and 60 mm Hg diastolic; supine blood pressure is 95 mm Hg systolic and 55 mm Hg diastolic. Initial lab tests demonstrate an elevated serum K+ and decreased Na+ levels of 5.5 mmol/l and 132 mmol/l, respectively

References

• http://autoimmune.pathology.jhmi.edu/diseases.cfm?systemID=3&DiseaseID=16