Addison's disease is an autoimmune disorder where the adrenal glands are destroyed and cannot produce sufficient adrenal hormones. A 30-year-old Caucasian woman presented with weakness, weight loss, and hyperpigmentation. Her blood tests showed low sodium and high potassium levels, consistent with Addison's disease due to her family history of autoimmune disease and physical exam findings. Addison's disease results from the body's immune system attacking the adrenal glands and destroying over 90% of the tissue, preventing production of vital cortisol and aldosterone hormones.

1. Addison’s Disease
Abdullatiff Sami Al-Rashed
Block 2.3
College of Medicine, King Faisal University
Al-Ahsa, Saudi Arabia

2. Objectives

3. Definition
• Addison’s disease is an autoimmune
inflammation of adrenal glands, resulting in their
gradual destruction and inability to make
sufficient amounts of adrenal hormones.
• Life threatening emergency.
• No Cortisol & Aldosterone.

4. Anatomy

5. Etiology

6. Epidemiology
• The frequency rate of Addison's disease:
• Addison's can afflict persons of any age, gender, or
ethnicity, but it typically presents in adults between 30
and 50 years of age
Human Population 1 in 10,000

7. Pathogenesis
• Addison’s disease occurs when more than 90%
of adrenal gland tissue is destroyed (primary
Addison’s disease).
• The destruction can occur due to various causes
that we discussed previously

8. Clinical Features

9. Clinical Features

10. Differential Diagnosis

11. The Case
• A 30 year old Caucasian women presents with
weakness and 4 kg weight loss in the past 3
months. Her friends are questioning why she has a
sun tan despite the winter season. Her medical
history is uneventful. Family history shows type 1
diabetes mellitus in a brother. On physical
examination her face, palmar creases and gingivae
appear to be hyper-pigmented. Sitting blood
pressure is 105 mm Hg systolic and 60 mm Hg
diastolic; supine blood pressure is 95 mm Hg
systolic and 55 mm Hg diastolic. Initial lab tests
demonstrate an elevated serum K+ and decreased
Na+ levels of 5.5 mmol/l and 132 mmol/l,
respectively

12. The Case
• A 30 year old Caucasian women presents with
weakness and 4 kg weight loss in the past 3
months. Her friends are questioning why she has a
sun tan despite the winter season. ?? Her medical
history is uneventful. Family history shows type 1
diabetes mellitus in a brother. On physical
examination her face, palmar creases and gingivae
appear to be hyper-pigmented. Sitting blood
pressure is 105 mm Hg systolic and 60 mm Hg
diastolic; supine blood pressure is 95 mm Hg
systolic and 55 mm Hg diastolic. Initial lab tests
demonstrate an elevated serum K+ and decreased
Na+ levels of 5.5 mmol/l and 132 mmol/l,
respectively

14. References
• http://autoimmune.pathology.jhmi.edu/dise
ases.cfm?systemID=3&DiseaseID=16