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Addison Disease

 Syn. Primary Adrenal Insufficiency , Primary adrenocortical insufficiency , Chronic primary adrenocortical insufficiency

Signs & Symptoms

 Fatigue
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults] Harrison [ 2735] Cecil [ 643]
Postural hypotension
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults] Harrison [ 2735]
Vomiting
Note: Correlates with the severity of adrenal insufficiency. A manifestation of GI disturbance
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults] Harrison [ 2735] Cecil [ 643]
Anorexia
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults] Harrison [ 2735] Cecil [ 643]

Physical Examination

 Hypotension
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults] Harrison [ 2735]
Weight loss #advanced
Note: The amount of weight lost can vary from 2 to as much as 15 kg and may not become evident until adrenal failure is advanced.
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults] Harrison [ 2735] Cecil [ 643]
Hypertension (negative symptom)
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults]

Lab / Serology

 Positive Adrenal autoantibodies
Note: More common in women, particularly those with the polyglandular autoimmune syndrome type 2.
Ref: Uptodate [ Causes of primary adrenal insufficiency (Addison's disease) Pathogenesis of autoimmune adrenal insufficiency] Harrison [ 2735-2537] Cecil [ 643]
Positive Steroid autoantibodies
Note: More common in women, particularly those with the polyglandular autoimmune syndrome type 2.
Ref: Uptodate [ Causes of primary adrenal insufficiency (Addison's disease) Pathogenesis of autoimmune adrenal insufficiency] Harrison [ 2735-2537] Cecil [ 643]
Positive Antiadrenal antibodies
Note: More common in women, particularly those with the polyglandular autoimmune syndrome type 2.
Ref: Uptodate [ Causes of primary adrenal insufficiency (Addison's disease) Pathogenesis of autoimmune adrenal insufficiency] Harrison [ 2735-2537] Cecil [ 643]

Imagin Study

 Splenomegaly
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults]
calcification of adrenal glands (negative symptom)
Ref: Uptodate [ Diagnosis of adrenal insufficiency in adults] Harrison [ 2736]
Enlarged adrenal glands (negative symptom)
Ref: Uptodate [ Diagnosis of adrenal insufficiency in adults] Harrison [ 2736]

Complication

 Confusion
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults]
Psychiatric symptoms
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults]
Impairment of memory
Ref: Uptodate [ Clinical manifestations of adrenal insufficiency in adults]

Risk Factors

Cause

 Autoimmune polyglandular syndrome 2
Note: More common in women
Ref: Uptodate [ Causes of primary adrenal insufficiency (Addison's disease) Pathogenesis of autoimmune adrenal insufficiency] Harrison [ 2733] Cecil [ 643]
Isolated autoimmune adrenalitis
Note: male 71%
Ref: Uptodate [ Causes of primary adrenal insufficiency (Addison's disease)] Harrison [ 2733-2734] Cecil [ 645]
HIV infection
Ref: Uptodate [ Causes of primary adrenal insufficiency (Addison's disease)] Harrison [ 2733-2734] Cecil [ 643, 645]

Other