What is Addison’s disease or primary adrenal insufficiency?

Addison’s disease is the insufficient production of hormones by the adrenal glands (cortisol, aldosterone) due to destruction or atrophy of the adrenal glands. Insufficient production of cortisol and aldosterone leads to adrenal crisis, dehydration and death.


What are the causes of Addison’s disease?

The destruction of the adrenal glands can be of:

  • autoimmune aetiology, which is the most common cause nowadays,
  • infectious aetiology, such as tuberculosis, fungal infection, HIV infection
  • haemorrhagic infarction
  • metastatic disease
  • medicines
  • adrenoleukodystrophy
  • familial glucocorticoid deficiency
  • congenital adrenal hypoplasia

Addison’s disease of autoimmune aetiology may be part of genetic syndromes characterized by multiple autoimmune endocrinopathies:

  • Autoimmune polyglandular syndrome type 1
  • Autoimmune polyglandular syndrome type 2

What is the incidence of the disease?

Addison’s disease is a rare disease with an incidence of 35-140 cases per million population.


What are the symptoms of the disease?

  • Weakness, severe fatigue
  • Malaise
  • Confusion
  • Muscle aches, bone and joints aches
  • Severe abdominal pain
  • Nausea, Vomiting
  • Anorexia
  • Desire to eat salty foods
  • Dark skin colour

Νεφρά επινεφρίδια - Σύνδρομο Cushing - πρωτοπαθής υπεραλδοστερονισμός - τυχαίωμα επινεφριδίων - Συγγενής υπερπλασία των επινεφριδίων - Νόσος Addison

What are the complications of the disease?

Patients with Addison’s disease are at risk of an adrenal crisis due to the inability of cortisol to rise in their blood, as it normally does under stress conditions.  The characteristics of the crisis are:

  • Hypotension
  • Malaise
  • Abdominal pain
  • Nausea, Vomiting
  • Electrolytic Abnormalities
  • Hypoglycemia
  • Dehydration
  • Hypovolemic shock
  • Death

How is the disease diagnosed?

The diagnosis of the disease is made by hormonal testing, special endocrine tests, imaging.


What is the treatment of Addison’s disease?

Treatment of Addison’s disease consists of physiological replacement of deficient hormones, training of patients for periods of stress and regular monitoring.