Addison’s disease

Adrenal insufficiency is the clinical manifestation of deficient production or action of glucocorticoids , with or without deficiency also in mineralocorticoids and adrenal androgensPrimary adrenal insufficiency is called Addison's disease

A rare disease AAFP quotes estimated prevalance at 1 in 20,000 persons in the US and Western Europe Wass J et al ( 2013 ) have reported that AD affects 1 in 10,000 in the UK and throughout Europe In children - boys are affected predominantly ( about 75 % of cases ) In adults majority who suffer with AD are women Presentation can be at any age

Primary – due to disease which is intrinsic to adrenal gland

Secondary-from pituitary disease that hampers the release of corticotrophin from a lack of responsiveness of the adrenal glands to the hormone.Secondary adrenal insufficiency is more common than AD

Tertiary - impaired synthesis or action of corticotrophin releasing hormone , arginine vasopressin or both from the hypothalamus which in turn inhibits secretion of corticotrophin ( ACTH ) from ant pituitary.

Most common cause of secondary adrenal insufficiency is exogenous steroid administration which induces atrophy pituitary corticotroph cells

Causes

Developed world- Autoimmune destruction of adrenal cortex in about 70 % of cases Other...