Addison’S Disease

(Addison’s disease; Primary, chronic adrenocortical insufficiency)

The Addison’s disease is an insidious, progressive underactive adrenal cortex. It causes characteristic symptoms such as hypotension, hyperpigmentation and may lead to an adrenergic crisis with cardiovascular circulatory collapse. The diagnosis is made based on the hospital and by measuring the increased adrenocorticotropic hormone (ACTH) level at low cortisol levels. Treatment usually consists of a hydrocortisone substitution. Occasionally, other hormones are substituted.

(See illustration of the adrenal function.)

The Addison’s disease is an insidious, progressive underactive adrenal cortex. It causes characteristic symptoms such as hypotension, hyperpigmentation and may lead to an adrenergic crisis with cardiovascular circulatory collapse. The diagnosis is made based on the hospital and by measuring the increased adrenocorticotropic hormone (ACTH) level at low cortisol levels. Treatment usually consists of a hydrocortisone substitution. Occasionally, other hormones are substituted. (See illustration of the adrenal function.) A Addison’s disease occurs in about 4 / 100,000 people per year. It comes in all ages ago, is evenly distributed to both sexes and is often only when metabolic stress or trauma clinical symptoms. The development of severe predominant symptoms (adrenergic crisis), by an acute infection (a common cause, especially during sepsis) are triggered. Other causes include intercurrent illness, surgery, or a sodium loss after excessive sweating. Even with treatment, Addison’s disease can cause a slight increase in mortality. It is not clear whether this increase is due to incorrectly treated Addison crises or long-term unintended About substitution. Etiology About 70% of all cases in the US are caused by idiopathic atrophy of the adrenal cortex. The presumably based on a autoimmune events. The remaining cases are caused by destruction of the adrenal gland by granulomas (z. B. in tuberculosis, histoplasmosis), tumors, amyloidoses, inflammatory hemorrhages or necrosis. A lack of corticosteroids may also be caused by drugs, which inhibit the synthesis of corticosteroids (eg., Ketoconazole, the anesthetic etomidate). A Addison’s disease can occur as part of a polyglandular autoimmune syndrome with a diabetes mellitus and a hypothyroidism. In children, the most common cause of primary adrenal insufficiency is congenital adrenal hyperplasia (CAH), but other genetic disorders are increasingly recognized as a cause. Pathophysiology There is a lack of mineralocorticoid and glucocorticoid. Since Mineralokortikoidmangel mineralocorticoids stimulate reabsorption of sodium and Kaliumexkretion, a deficiency results predominantly in the urine, but also in saliva, sweat, and in the GI tract to increased sodium excretion and decreased excretion of potassium. From this followed a decreased serum sodium concentration and an increased serum concentration of potassium. Urinsalz- and water loss cause severe dehydration, Plasmahypertonizität, acidosis, humiliated circulating volume, hypotension, and at worst a circulatory collapse. If the adrenal insufficiency caused by an inadequate ACTH production (secondary adrenal insufficiency), the electrolyte values ??are often normal or only slightly changed and the circulatory problems are less ernst.Glukokortikoidmangel A Glukokortikoidmangel causes hypotension and leads to increased insulin sensitivity and to disturbances in carbohydrate , fat and protein metabolism. In an adrenocortical insufficiency too little carbohydrates are obtained from protein, which then leads to hypoglycemia and reduced glycogen in the liver. Patients feel, partly due to a failure of neuromuscular function weak. The resistance to infection, trauma and other forms of stress is limited. Myocardial weakness and dehydration reduce cardiac output and heart and circulatory failure may occur. A reduced cortisol in the blood leads to an increased pituitary ACTH production and increased blood levels of beta-lipotropin, which has melanocyte effect and causes together with the ACTH so characteristic for Addison’s disease hyperpigmentation of skin and mucous membranes. Adrenal insufficiency in a hypopituitarism does not cause hyperpigmentation. Symptoms and complaints of weakness, fatigue and orthostatic hypotension are early symptoms of Addison’s disease. The Hyperpigmentierungn is characterized by diffuse browning of the exposed to sunlight the body. The non-exposed parts of the body dark little less, and here are mainly pressure points (bony protrusions), skin wrinkles, scars, and the extensor surfaces of the extremities affected. Black hyperpigmentation occur more frequently on the forehead, neck, face and shoulders on. It is a blue-black discoloration in the area of ??nipples and mucous membranes developed at the lips, mouth, rectum and vagina. Hyperpigmentation in Addison © Springer Science + Business Media var model = {thumbnailUrl: ‘/-/media/manual/professional/images/505-hyperpigmentation-of-addison-disease-s101-springer-high_de.jpg?la=de&thn= 0 & mw = 350 ‘, imageUrl’ /-/media/manual/professional/images/505-hyperpigmentation-of-addison-disease-s101-springer-high_de.jpg?la=de&thn=0 ‘title’ in Crohn hyperpigmentation Addison ‘description:’ u003Ca id = “v37895308 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003ePatienten with Addison’s disease have diffuse hyperpigmentation and hyperpigmentation on the extensor surfaces (here

Health Life Media Team

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