Addison's disease ("bronze disease") is a rare disease of the endocrine system, first described in the middle of the XIX century by the English doctor-therapist T. Addison. People who are between the ages of 20 and 50 are most susceptible to the disease. What happens in the body with this pathology, what are the causes of its occurrence and modern methods of treatment, we will consider further.
Addison's disease - etiology and pathogenesis
Addison's disease is caused by bilateral damage to the adrenal cortex. In this case, there is a significant reduction or complete cessation of the synthesis of hormones, especially glucocorticoids (cortisone and hydrocortisone) regulating protein, carbohydrate and fat metabolism, as well as mineralocorticoids (deoxycorticosterone and aldosterone) responsible for the regulation of water-salt metabolism.
A fifth of the cases of this disease are of unknown origin. Of the known causes of Addison's disease, we can distinguish the following:
- autoimmune lesion of the adrenal cortex;
- AIDS;
- syphilis;
- adrenoleukodystrophy;
- tuberculosis of the adrenal glands;
- amyloidosis ;
- sarcoidosis;
- removal of the adrenal glands;
- hemorrhages in the adrenal glands;
- long-term treatment with hormones;
- fungal lesions.
A decrease in the production of mineralocorticoids leads to the fact that the body loses sodium in large amounts, is dehydrated, and the volume of circulating blood and other pathological processes also decrease. The lack of synthesis of glucocorticoids leads to violations of carbohydrate metabolism, a drop in blood sugar, and vascular insufficiency.
Symptoms of Adison's Disease
As a rule, the development of Addison's disease occurs slowly, from several months to several years, and its symptoms often go unnoticed for a long time. The disease can occur when the body has an acute need for glucocorticoids, which can be associated with any stress or pathology.
Symptoms of the disease include:
- fast fatiguability;
- muscle weakness;
- decreased memory;
- weight loss;
- disruption of the gastrointestinal tract;
- low blood pressure;
- hyperpigmentation of the skin (spots of bronze color) - occurs long before the appearance of other symptoms;
- Attraction to salty and sour food;
- thirst;
- irregular menstruation;
- tremor of hands , head;
- excess urine;
- tachycardia and others.
Addisonian crisis
If the symptoms of the disease occur unexpectedly quickly, acute adrenocortical insufficiency occurs. This condition is called "addisonian crisis" and is life threatening. It manifests itself by such signs as sudden severe pain in the lower back, abdomen or legs, severe vomiting and diarrhea, loss of consciousness, brown plaque on the tongue, etc.
Addison's disease - diagnosis
If Addison's disease is suspected, laboratory tests are performed to detect a decrease in sodium levels and potassium levels, a decrease in serum glucose, a low content of corticosteroids in the blood, an increased content of eosinophils, and others.
Addison's disease - treatment
The treatment of the disease is based on drug substitution hormone therapy. As a rule, the lack of cortisol is replaced by hydrocortisone, and the lack of a mineral corticosteroid
With Addison's crisis, intravenous glucocorticoids and large volumes of saline solutions with dextrose are prescribed, which allows to improve the condition and remove the threat of life.
Treatment involves a diet that restricts the consumption of meat and the exclusion of baked potatoes, legumes, nuts, bananas (to limit the intake of potassium). The norm of consumption of salt, carbohydrates and vitamins, especially C and B, is increasing. The prognosis with adequate and timely treatment of Addison's disease is quite favorable.