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Addison's disease - Wikipedia

Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a rare long-term endocrine disorder characterized by inadequate production of the steroid hormones cortisol and aldosterone by the two outer layers of the cells of the adrenal gland (adrenal cortex). Symptoms generally come on slowly and may include abdominal pain and gastrointestinal abnormalities, weakness, and weight loss. Darkening of the skin in certain areas may also occur. Under certain circumstances, an adrenal crisis may occur with low blood pressure, vomiting, lower back pain, and loss of consciousness. Mood changes may also occur. Rapid onset of symptoms indicates acute adrenal failure which is a serious and emergent condition. An adrenal crisis can be triggered by stress, such as from an injury, surgery, or infection.

edit summary: added, "rare long-term endocrine disorder characterized by inadequate production of the steroid hormones cortisol and aldosterone by the two outer layers of the cells of the adrenal gland (adrenal cortex)." as well as, Mood changes may also occur. Rapid onset of symptoms indicates acute adrenal failure which is a serious and emergent condition. Added citation

Addison's disease can be described in association with chronic mucocutaneous candidias, diabetes mellitus, pernicious anemia, hypogonadism, chronic and active hepatitis, malabsorption, immunoglobin abnormalities, alopecia, vitiligo, spontaneous myxedema, Grave's Disease, and chronic lymphocytic thyroiditis.

edit summary: added to elaborate on possible coexisting conditions, added citation

Skin Changes:


 * Hyperpigmentation of the skin
 * Vitiligo

Gastrointestinal Changes


 * Nausea and vomiting
 * Weight loss
 * abdominal pain
 * Less common but still occurring: malnutrition and muscle wasting

Behavioral Disorders


 * Anxiety
 * Depression
 * Irritability
 * Poor Concentration

Changes in Females


 * Loss or irregularity of menstrual cycle
 * Loss of body hair
 * decreased sexual drive

edit summary: visually appealing way to break down information about specific symptoms, added citation.

Causes of adrenal insufficiency can be categorized by the mechanism through which they cause the adrenal glands to produce insufficient cortisol. This can be due to damage or destruction of the adrenal cortex. These deficiencies include glucocorticoid and mineralocorticoid hormones as well. These are adrenal dysgenesis (the gland has not formed adequately during development), impaired steroidogenesis (the gland is present but is biochemically unable to produce cortisol), or adrenal destruction (disease processes leading to glandular damage).

edit summary: added, " This can be due to damage or destruction of the adrenal cortex. These deficiencies include glucocorticoid and mineralocorticoid hormones as well. to enhance understanding of possible causes as well as citation

Individuals with Addison's disease have more than a doubled mortality rate. Furthermore, individuals with Addison's disease and diabetes mellitus have an almost 4 times increase in mortality compared to individuals with only diabetes. The risk ratio for cause mortality in males and females is 2.19 and 2.86 respectively.

Death from individuals with Addison's disease often occurs due to cardiovascular disease, infectious disease, and malignant tumors among other possibilities.

edit summary: Added risk ratio and cause of death as well as citation

The frequency rate of Addison's disease in the human population is sometimes estimated at roughly one in 100,000. Some put the number closer to 40–144 cases per million population (1/25,000–1/7,000). Addison's can affect persons of any age, sex, or ethnicity, but it typically presents in adults between 30 and 50 years of age. Research has shown no significant predispositions based on ethnicity. Approximately 70% of Addison's Disease diagnoses occur due to autoimmune reaction which caused damage to the adrenal cortex.

edit summary: "Approximately 70% of Addison's Disease diagnoses occur due to autoimmune reaction which caused damage to the adrenal cortex." and citation

The condition was initially considered a form of anemia associated with the adrenal glands. Because little was known at the time about the adrenal glands (then called "Supra-Renal Capsules"), Addison's monograph describing the condition was an isolated insight. As the adrenal function became better known, Addison's monograph became known as an important medical contribution and a classic example of careful medical observation.

edit summary: Tuberculosis used to be a major cause of Addison's Disease and acute adrenal failure and still still a leading cause in developing countries today.