Addison Disease Questions & Answers

Updated: Feb 13, 2018
  • Author: George T Griffing, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Questions & Answers

Overview

What is Addison disease?

When was Addison disease first described?

How is adrenocortical insufficiency in Addison disease diagnosed?

Which lab testing should be performed prior to treatment of an acute adrenal crisis in Addison disease?

Which lab testing and imaging studies should be performed in the diagnosis of Addison disease?

Which drugs are used for replacement therapy in Addison disease and what is the drug of choice?

How is acute adrenal crisis in Addison disease managed?

What is the prevalence of Addison disease in the US?

What is the international prevalence of Addison disease?

What causes morbidity and mortality in Addison disease?

What is a potential outcome of acute addisonian crisis if not treated promptly?

How is slow-onset chronic Addison disease characterized?

What is the risk of death in patients with Addison disease after diagnosis and treatment?

Which conditions increase the risk for adrenal crisis in Addison disease?

What are mortality rates in patients with Addison disease and type 1 or 2 diabetes?

What is the racial predilection of Addison disease?

Is Addison disease more common in men or women?

What are the age-related demographics of Addison disease?

Presentation

How is the typical presentation of Addison disease characterized?

How is the onset of symptoms characterized in Addison disease?

How is hyperpigmentation of the skin in Addison disease characterized?

What are other skin findings in Addison disease?

Which constitutional symptoms are associated with Addison disease?

Which GI symptoms are associated with Addison disease?

What are the symptoms and causes of syncope in Addison disease?

What causes myalgias and flaccid muscle paralysis in Addison disease?

What medication history may be associated with Addison disease?

Which types of pain and sensory symptoms are associated with Addison disease?

How can Addison disease affect the course of diabetes that was previously well-controlled?

Which reproductive systems can be affected by Addison disease?

What is the presentation of acute adrenal crisis in Addison disease?

What are the physical exam findings in Addison disease?

What is the cause and pathophysiology of Addison disease?

Which autoimmune conditions are associated with chronic Addison disease?

How do chronic granulomatous diseases cause chronic Addison disease?

How do hematologic malignancies cause chronic Addison disease?

Which metastatic malignancies are associated with the development of chronic Addison disease?

How do infiltrative metabolic disorders cause chronic Addison disease?

What is the role of AIDS in the development of chronic Addison disease?

What is the relationship between Allgrove syndrome and chronic Addison disease?

How do abnormalities of beta oxidation of very-long-chain fatty acids cause chronic Addison disease?

How does congenital adrenal hyperplasia cause chronic Addison disease?

Which drugs can cause chronic Addison disease?

How does abdominal irradiation cause chronic Addison disease?

How does stress cause acute Addison disease?

How does failure to adjust steroid medications cause acute Addison disease?

What is the role of bilateral adrenal hemorrhage in the development of acute Addison disease?

How do bilateral adrenal artery emboli and bilateral vein thrombosis cause acute Addison disease?

How does bilateral adrenalectomy cause acute Addison disease?

DDX

What are the differential diagnoses for Addison Disease?

Workup

When should Addison disease be suspected?

What is the role of the rapid ACTH stimulation test in the workup of Addison disease?

How is a rapid adrenocorticotrophic hormone test performed in the workup of Addison disease?

How is the rapid adrenocorticotrophic hormone test interpreted in the workup of Addison disease?

What is the role of random plasma cortisol testing in the workup of Addison disease?

How is a comprehensive metabolic panel used in the workup of Addison disease?

How is a CBC used in the workup of Addison disease?

How is a thyroid-stimulating hormone (TSH) test used in the workup of Addison disease?

How is autoantibody testing used in the workup of Addison disease?

How is prolactin testing used in the workup of Addison disease?

How is chest radiography used in the workup of Addison disease?

How is CT scanning used in the workup of Addison disease?

What findings may be demonstrated in an ECG in the workup of Addison disease?

Which tests are indicated when TB is suspected as the cause of Addison disease?

What are the histologic findings of Addison disease in cases due to idiopathic autoimmune adrenocortical atrophy?

What are the histologic findings of Addison disease in cases due to TB?

What are the histologic findings of Addison disease in patients with AIDS?

Treatment

What is the initial medical care for acute adrenal crisis in Addison disease?

What is the initial medical care for stress situations in Addison disease?

How soon after medical care is initiated should clinical improvement be evident in acute adrenal crisis in Addison disease?

How is stress GI bleeding avoided in Addison disease?

When should the initial hydrocortisone infusion be transitioned to mineralocorticoid replacement for acute adrenal crisis in Addison disease?

What should patients with Addison disease be advised to do in hot weather?

When is parenteral steroid coverage indicated in the management of Addison disease?

How is steroid therapy adjusted during and after surgical procedures in Addison disease?

When is consultation with an endocrinologist recommended in the treatment of Addison disease?

Guidelines

What are the treatment guidelines for primary and secondary adrenal insufficiency by the French Endocrinology Society and the French Pediatric Endocrinology Society?

Medications

What are the goals of pharmacotherapy in Addison disease?

Which medications in the drug class Corticosteroid are used in the treatment of Addison Disease?