What do doctors call this condition - Adrenal hypofunction, adrenal insufficiency

What is this Vondition?

In this disorder, the adrenal glands don’t secrete enough steroid hormones. A relatively uncommon disorder, Addison’s disease can occur at any age and in both sexes. With early diagnosis and adequate replacement of the steroid hormones, the prognosis for Addison’s disease is good.

Adrenal crisis (also known as addisonian crisis), a critical shortage of steroid hormones, generally follows acute stress, sepsis, injury, surgery, or failure of people with chronic adrenal insufficiency to take steroids. Because it’s a medical emergency, adrenal crisis requires immediate, vigorous treatment.

What Causes it?

Addison’s disease occurs when more than 90% of both adrenal glands are destroyed. In primary Addison’s disease, such destruction usually results from an autoimmune process in which circulating antibodies react specifically against the adrenal tissue. Other possible causes include tuberculosis, adrenal gland surgery, hemorrhage, and certain cancers or infections. Rarely, a person inherits a predisposition for developing Addison’s disease and other endocrine disorders.

Secondary Addison’s disease results from a disorder outside the gland (such as a pituitary tumor).

What are its Symptoms?

Addison’s disease typically causes weakness, fatigue, weight loss, and gastrointestinal disturbances, such as nausea, vomiting, loss of appetite, and chronic diarrhea. Also, it usually causes a conspicuous bronze skin discoloration - almost like a deep suntan - most noticeable in the creases of the hands, but also on the hand joints, elbows, and knees. It may darken scars and increase pigmentation of the mucous membranes.

The disorder may affect the heart and blood vessels, causing low blood pressure and a weak, irregular pulse. Other possible symptoms include a reduced tolerance for stress (even when minor), poor coordination, and a craving for salty food. In women, Addison’s disease may retard the growth of underarm and pubic hair, reduce the libido, and, in severe cases, cause menstruation to stop.

Secondary Addison’s disease produces symptoms similar to those of the primary type but doesn’t cause hyperpigmentation.

Adrenal crisis produces profound weakness, fatigue, nausea, vomiting, low blood pressure, dehydration and, occasionally, high fever followed by hypothermia. If untreated, this condition can progress to vascular collapse, kidney failure, coma, and death.

How is it Diagnosed?

Lab tests are key to diagnosing Addison’s disease. The doctor will require blood samples to measure plasma cortisol levels to confirm adrenal insufficiency If secondary Addison’s disease is suspected, he or she may order a special test called the metyrapone test, For primary or secondary Addison’s disease, the doctor will probably order a corticotropin stimulation test.

How is it Treated?

Lifelong hormone replacement therapy with steroid drugs is the primary treatment for people with Addison’s disease. The person usually receives the drugs cortisone or hydrocortisone, He or she may also require treatment with drugs to prevent dangerous dehydration and low blood pressure, Such drugs may include desoxycorticosterone or fludrocortisone,

Adrenal crisis constitutes a medical emergency and requires immediate medical intervention. Interventions include large doses of hydrocortisone. With proper treatment, adrenal crisis usually sub­sides quickly.