Addison's Disease

The adrenal glands are paired endocrine organs that produce hormones secondary to neuronal influence. The glands are organized into an inner adrenal medulla that secretes Adrenaline and Noradrenaline and an outer cortex consisting of three anatomically and functionally different layers producing mineralocorticoids (aldosterone), glucocorticoids (cortisol) and androgens (androstenedione).The gland may suffer disorders of hyperfunction such as hypercortisolism, pheochromocytoma and hyperaldosteronism or disorders of insufficiency such as Addison’s disease. This article will provide outlines for each disease separately.

Adrenal insufficiency is defined as inadequate production of adrenocortical hormones (glucocorticoids, mineralocorticoids, and adrenal androgens). Adrenal insufficiency can be primary or secondary. Primary adrenal insufficiency (Addison's disease) is caused by diseases in the gland itself, and the most common cause is  autoimmune adrenalitis. Secondary adrenal insufficiency occurs due to decreased production of ACTH either from prolonged glucocorticoid therapy or disease in pituitary/hypothalamic glands. Glucocorticoids therapy is required for both forms of Adrenal insufficiency. Adrenal crisis is a well-recognized life-threatening complication that requires high doses of hydrocortisone and intravenous fluids.