Addison's disease and addisonic crisis


  • What is Addison's disease
  • Symptoms of Addison's disease
  • What is addisonic crisis

  • What is Addison's disease

    Addison disease (chronic lack of adrenal cortex, or hypocorticism, eng. ADDISON'S DISEASE) — Rare endocrine disease, as a result of which adrenal glands lose the ability to produce enough hormones, primarily cortisol. This pathological condition was first described by the British therapist Thomas Addison in its publication of 1855, entitled the constitutional and local consequences of the disease of the adrenal cortex.

    Addison's disease may occur due to the primary failure of the adrenal cortex (in which the adrenal bark itself is affected or poorly functions), or the secondary insufficiency of the adrenal cortex, in which the front proportion of the pituitary is not enough adrenocorticotropic hormone (ACTH) for adequate stimulation of adrenal cortex.

    Addison's disease usually develops slowly, for several months or years, and its symptoms can remain unnoticed or not manifest as long as any stress or disease does not happen, sharply improving the need of the body in glucocorticoids.

    Symptoms of Addison's disease

    The most frequent symptoms of Addison's disease:

    • Chronic fatigue gradually aggravated over time;
    • Muscle weakness;
    • Weight loss and appetite;
    • Nausea, vomiting, diarrhea, abdominal pain;
    • Low blood pressure, even more declining in the standing position (orthostatic hypotension);
    • Hyperpigmentation of the skin in the form of spots in places that are subjected to solar irradiation;
    • Dysphoria, irritability, quick temper, dissatisfaction with everyone;
    • Depression;
    • Attraction to salt and salty food, thirst, abundant drinking liquid;
    • Hypoglycemia, low blood glucose level;
    • Menstruation women become irregular or disappear, men develop impotence;
    • Tetania (especially after milk consumption) due to excess phosphates;
    • Paresthesias and impaired sensitivity of the limbs, sometimes up to paralysis, due to the excess of potassium;
    • Increased amount of eosinophils in the blood;
    • excess amount of urine;
    • Hypovolemia (reduction of circulating blood volume);
    • Dehydration (dehydration of the body);
    • Tremor (hand shake, head);
    • Tachycardia (rapid heartbeat);
    • Anxiety, anxiety, internal tension;
    • Dysphagia (swallowing).

    What is addisonic crisis

    Addison's disease and addisonic crisis
    In some cases, Addison's symptoms may occur unexpectedly quickly. Such a state of acute insufficiency of adrenal cortex is called «Addisonic crisis» and is extremely dangerous who threatens the life of a patient. Any acute disease, blood loss, injury, operation or infection can exacerbate existing adrenal insufficiency, which can lead to addisonic crisis. Addisonic crises are most frequent in undiagnosed or not receiving treatment, or received inadequately small, insufficient dose of corticosteroids of patients with Addison disease, or in those whom the dose of glucocorticoids was not temporarily increased with disease, stress, surgery and T. NS.

    In previously diagnosed and receiving adequate treatment of patients, addisonic crisis may occur as a result of a sharp cessation of corticosteroids or a sharp decline in their dose, or with an increase in the body's needs in glucocorticoids (operations, infections, stress, injury, shock).

    Addisonic crisis may also arise in patients who do not suffer from Addison's disease, but receiving or received in the recent past long-term treatment with glucocorticoids about other diseases (inflammatory, allergic, autoimmune, etc.) with a sharp reduction in the dose or cutting cancellation of glucocorticoids, as well as when improving the body's need for glucocorticoids. The reason for this is the oppression of the exogenous glucocorticoids of the secretion of ACTG and endogenous glucocorticoids, gradually developing functional atrophy of the adrenal cortex during long-term glucocorticoid treatment, as well as a decrease in the sensitivity of tissue receptors to glucocorticoids (desensitization) with therapy with supraphysiological doses, which leads to the patient's dependence on the admission of exogenous glucocorticoids into the body («Steroid addiction»).

    Symptoms of addisonic crisis:

    • Sudden severe pain in the legs, lower back or belly;
    • Severe vomiting, diarrhea, leading to dehydration and shock development;
    • Sharp decrease in blood pressure;
    • Loss of consciousness;
    • Acute psychosis or confusion of consciousness, delirium;
    • A sharp decrease in blood glucose levels;
    • Hyponatremia, hypercalemia, hypercalcemia, hyperphosphatemia;
    • Brown raid in language and teeth due to hemolysis and iron deficiency development.

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