What is Addison's disease
Addison's disease (chronic insufficiencyadrenal cortex, or gipokortitsizm, Eng. Addison's disease) - a rare endocrine disorder in which the adrenal glands lose their ability to produce enough hormones, especially cortisol. This pathological condition was first described by the British physician Thomas Addison in his publication of 1855, entitled Constitutional and Local Effects of the disease of the adrenal cortex.
Addison's disease may be due toprimary adrenal insufficiency (in which impressed itself or poorly functioning adrenal cortex), or secondary adrenal insufficiency, in which the anterior pituitary produces enough adrenocorticotropic hormone (ACTH) to adequately stimulate the adrenal cortex.
Addison's disease usually develops slowlywithin a few months or years, and its symptoms may go unnoticed or may not occur as long as does not happen any stress or disease, dramatically increases the body's need glucocorticoids.
The symptoms of Addison's disease
The most common symptoms of Addison's disease:
- Chronic fatigue, gradually getting worse over time;
- Muscle weakness;
- Loss of weight and appetite;
- Nausea, vomiting, diarrhea, abdominal pain;
- Low blood pressure, decreasing even more in a standing position (orthostatic hypotension);
- Hyperpigmentation of the skin in the form of spots in places exposed to solar radiation;
- Dysphoria, irritability, temper, resentment all;
- Craving for salt and salty foods, thirsty, drink plenty of fluids;
- Hypoglycemia, low blood glucose;
- In menstruating women become irregular or disappear, men develop impotence;
- Tetany (especially after drinking milk), due to an excess of phosphates;
- Paresthesias and sensory disturbances of limbs, sometimes to the point of paralysis, due to an excess of potassium;
- The increased number of eosinophils in the blood;
- an excessive amount of urine;
- Hypovolemia (decreased circulating blood volume);
- Dehydration (dehydration);
- Tremor (trembling of the hands, head);
- Tachycardia (increased heart rate);
- Anxiety, anxiety, inner tension;
- Dysphagia (swallowing disorders).
What addisonichesky crisis
In some cases, the symptoms of Addison's diseasecan arise unexpectedly. Such a state of acute adrenal insufficiency is called "a crisis of addisonicheskim" and is extremely dangerous, life-threatening condition of the patient. Any acute illness, blood loss, trauma, surgery or infection can aggravate an existing adrenal insufficiency, which can lead to addisonicheskomu crisis. Addisonicheskie crises are most frequent from undiagnosed or untreated or treated inadequately small, insufficient dose corticosteroids in patients with Addison's disease, or those who dose of glucocorticoids was not temporarily increased during illness, stress, surgery, and so on. N.
In previously diagnosed and treated adequatelytreated patients addisonichesky crisis can result from abrupt discontinuation of treatment with corticosteroids or sharp decrease their doses, or by increasing the body's need for glucocorticoids (surgery, infection, stress, trauma, shock).
Addisonichesky crisis can also occur inpatients not suffering from Addison's disease, but treated or treated in the recent past, prolonged steroid treatment for other diseases (inflammatory, allergic, autoimmune, etc.) with a sharp decrease in the dose or abrupt cancellation of glucocorticoids, as well as improving the body needs glucocorticoids. This is due to inhibition of exogenous glucocorticoid secretion of ACTH and endogenous glucocorticoids, gradually developing functional atrophy of the adrenal cortex by prolonged glucocorticoid treatment, and reduced tissue sensitivity of receptors for glucocorticoids (desensitization) in the treatment of supraphysiological doses, which leads to a dependence of the patient on admission of exogenous glucocorticoids in the body ( "steroid dependence").
Symptoms addisonicheskogo crisis:
- Sudden severe pain in the legs, lower back or abdomen;
- Vomiting, diarrhea, dehydration and leading to the development of shock;
- The sharp decline in blood pressure;
- Loss of consciousness;
- Acute psychosis or confusion, delirium;
- The sharp decline in blood glucose levels;
- Hyponatremia, hyperkalemia, hypercalcemia, hyperphosphatemia;
- Brown patches on the tongue and teeth due to hemolysis and the development of iron deficiency.