Addison's disease

(Thomas Addison, 1793 - 1860, English physician), an endocrine disorder caused by destruction of the adrenal cortex and characterized by a deficiency in aldosterone and cortisol. For a general description, see Addisons disease.

The most common cause of Addison's disease is idiopathic atrophy of the adrenal glands, perhaps related to an autoimmune disorder. Additional causes are infections (such as tuberculosis or fungal diseases) or infiltrating neoplasms. The clinical manifestations are manifold (weight loss, weakness, hypovolaemia, hypotension, decreased cardiac output, prerenal azotaemia, acidosis, syncope, shock, anorexia, nausea, vomiting, abdominal pain, lethargy, psychosis, hypotension, hypoglycaemia, hyperpigmentation), but musculoskeletal manifestations are not frequent or prominent. Findings include migratory myalgias, back pain and sciatica. Additional abnormalities are the Guillain Barr syndrome, hyperkalaemic neuromyopathy, hyponatremic myopathy and flexion deformities. Radiographs in patients with Addison's disease may reveal calcification in the adrenal glands, external ear, periarticular areas and costal cartilages. Skeletal maturation may be delayed.

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