Addison Disease

Tya-Mae Y. Julien, MD Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Primary adrenal gland insufficiency, which results from partial or complete destruction of the adrenal cells with inadequate secretion of glucocorticoids and mineralocorticoids

  • 80% of...

DIAGNOSIS

HISTORY

  • Weakness, fatigue

  • Dizziness

  • Anorexia, nausea, vomiting

  • Abdominal pain

  • Chronic diarrhea

  • Depression (60–80% of patients)

  • Decreased cold tolerance

  • Salt craving

PHYSICAL EXAM

  • Weight loss

  • Low BP, or...

TREATMENT

GENERAL MEASURES

Consider the 5 S’s for the management of adrenal crisis: 
  • Salt, sugar, steroids, support, and search for a precipitating illness (usually infection, trauma, recent surgery, or...

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

  • Verify adequacy of therapy: normal BP, serum electrolytes, plasma renin, and fasting blood glucose level

  • Periodically assess for the development of long-term compli...

REFERENCES

Bornstein SR, Allolio B, Arlt W et al. Diagnosis and treatment of primary adrenal Insufficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab.  2016;101(2...

ADDITIONAL READING

SEE ALSO

Algorithm: Adrenocortical Insufficiency 

CODES

ICD10

  • E27.1 Primary adrenocortical insufficiency

  • A18.7 Tuberculosis of adrenal glands

  • E27.2 Addisonian crisis

ICD9

  • 255.41 Glucocorticoid deficiency

  • 017.60 Tuberculosis of adrenal glands, unspecified

SNOMED

PEARLS

  • 80% of cases are caused by an autoimmune process; the average age of diagnosis in adults is 40 years.

  • Consider the 5 S’s for the management of Addison disease: salt, sugar, steroids, support, an...

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