Addison's disease - a painful condition of the adrenal cortex that occurs during their bilateral lesions, resulting in a decrease (or eliminate) the secretion of adrenal hormones. It is also known as "bronze disease" or chronic insufficiency of the adrenal cortex.

Addison's disease occurs when the defeat of more than 90% of the adrenal tissue. In most cases, the cause of the disease - an autoimmune process (attack its own immune system), followed in frequency should be tuberculosis.

As syndrome, chronic adrenocortical insufficiency is present in the set of inherited diseases.

Causes

• autoimmune lesion of the adrenal cortex (the immune system attacks its own)
• adrenal tuberculosis
• removal of the adrenal glands
• the effects of long-term hormone therapy
• fungal infections (histoplasmosis, blastomycosis, coccidioidomycosis)
• sarcoidosis
• bleeding into the adrenal glands
• tumor
• amyloidosis
• acquired immunodeficiency syndrome (AIDS)
• syphilis
• adrenoleukodystrophy.

The symptoms of Addison's disease

Addison's disease is accompanied by increased levels of adrenocorticotropic hormone (ACTH), together with the alpha-melanocyte stimulating hormone, causes darkening of the skin and mucous membranes - the hallmark of Addison's disease, and therefore it is also called "bronze."

Secondary insufficiency of the adrenal cortex gland failure due to brain - the pituitary gland; Unlike primary never accompanied by skin darkening.

The manifestations of Addison's disease are made up of signs of inadequate allocation of adrenal hormones. The predominance of certain manifestations determined by the duration of the disease.

• Darkening of the skin and mucous membranes (when the primary failure) often for months or years ahead of other manifestations. The simultaneous presence of vitiligo is due to autoimmune destruction of melanocytes, the cells responsible for skin color.
• Extreme weakness (especially muscle), fatigue, weight loss, poor appetite.
• Lowering blood pressure (hypotension), which is accompanied by vertigo. Also due to low blood pressure patients reported poor cold tolerance.
• Signs lesions of the gastrointestinal tract: nausea, vomiting, diarrhea episodic.
• There are mental disorders (depression, psychosis).
• Strengthening the taste, olfactory, auditory sensitivity; you may receive an irresistible desire to salty foods.

The adrenal (adrenal) crises
This extreme manifestation of Addison's disease (more info).

They are based on a sudden deficiency of adrenal hormones due to increasing demand for them, or a sudden decrease in their production against the background of already existing chronic adrenal insufficiency.

Causes of adrenal crisis:

• Stress: an acute infectious disease, trauma, surgery, emotional stress and other stress factors. The adrenal crises in these situations provoke a lack of adequate increasing doses of hormone replacement therapy.
• Bilateral adrenal hemorrhage.
• Bilateral adrenal artery embolism or thrombosis of the adrenal veins (eg, during the X-ray contrast studies).
• Removal of the adrenal glands without adequate replacement therapy.

Manifestations of adrenal crisis:

• lowering blood pressure,
• stomach ache,
• vomiting
• impaired consciousness.

Diagnostics

Diagnosis is made endocrinologist and is reduced to identifying insufficient functionality of the adrenal cortex (to increase the synthesis of the hormone cortisol in response to a stimulating effect).
Treatment of Addison's disease

Therapy

• Adrenal hormone replacement therapy. Apply hydrocortisone and fludrocortisone.
• Hydrocortisone 10 mg in the morning and 5 mg orally every day after dinner (adults up to 20-30 mg / day.).
• Fludrocortisone at 0.1-0.2 mg orally 1 time a day.
• When blood pressure increase the dose should be reduced. In acute disease (such as a cold) or after a minor trauma double dose of hormones until feeling better.
• When surgical treatment before and (if necessary) after the surgery correcting the dose of hormones. In diseases of the liver, as well as elderly patients doses should be reduced.

Diet for Addison's disease:

• A sufficient amount of protein, fat, carbohydrates and vitamins, especially C and B (recommend a decoction of rose hips, black currants, brewer's yeast).
• Table salt consumed in large amounts (20 g / d.).
• The diet of potato reduced the content of peas, beans, beans, dried fruits, coffee, cocoa, chocolate, nuts, mushrooms.
• Vegetables, meat, fish should be consumed in cooked form.
• Diet fractional before bedtime recommend a light dinner (glass of milk).

Forecast

With adequate treatment of Addison's disease prognosis. Life expectancy is close to normal.