Summary RNSG 1341 Addison and Cushings disease Lecture Notes

ADDISON’S & CUSHING’S DISEASE



• Addison’s Disease or Addisonian Crisis: Lack of adrenal cortex hormones or withdrawal

corticosteroid medication

• Cushing’s Syndrome or Disease-Excess adrenal cortex hormones or too much

corticosteroid medication

• Adrenal Cortex hormones:

• Stimulated by ACTH release from anterior pituitary

Glucocorticoids

• Regulate metabolism (fat, protein, carbohydrate) ↑ blood glucose

• Suppress inflammation

• Critical in physiologic stress response

• Control sleep/wake pattern

• Can decrease bone formation

Mineralocorticoids-Aldosterone

• Regulate sodium and potassium balance

• Regulate fluids

Androgens

• Involved in growth and development, sexual activity




ADDISON’S DISEASE

, Primary (it’s the adrenal cortex’s fault)

• Addison’s disease

• Lack of glucocorticoids, mineralocorticoids, and androgens

Secondary (it’s the pituitary’s fault)

• Lack of pituitary ACTH

• Lack of glucocorticoids and androgens

One other: withdrawal of corticosteroid medication

Autoimmune response against adrenal cortex-70-90%

• May have other autoimmune diseases: Type I diabetes, autoimmune thyroid

diseases, pernicious anemia, celiac disease)

TB (uncommon in US), fungal infections, AIDS, metastatic cancer

Iatrogenic (illness caused by treatment):

• e.g. Adrenal hemorrhage-anticoagulants, surgery-adrenalectomy, drugs-

chemotherapy.

S/S

• Hyperpigmentation

• Orthostatic hypotension

• ↓ Na and salt craving

• ↑K

• ↑ Ca

• Abdominal Pain, nausea and vomiting, diarrhea

• ↓ glucose