Addison’s Disease – High-Yield Causes, Symptoms & Diagnosis | MBBS/USMLE

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Conceptual diagram of Addison’s Disease showing causes, symptoms, and diagnosis for MBBS and USMLE students
Addison’s Disease (Primary Adrenal Insufficiency) is a crucial high-yield topic in endocrinology for MBBS and USMLE exams. A strong grasp of its causes, clinical presentation, and diagnostic findings helps in quick identification and differentiation from other adrenal disorders.
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Addison’s Disease, also known as primary adrenal insufficiency, is a condition characterized by the destruction or dysfunction of the adrenal cortex, leading to deficient production of cortisol and aldosterone. The most common cause worldwide is autoimmune adrenalitis, while infections such as tuberculosis remain significant in developing regions.

The deficiency of cortisol results in symptoms like fatigue, weight loss, and hypotension, whereas aldosterone deficiency leads to hyponatremia, hyperkalemia, and dehydration. A hallmark clinical feature is hyperpigmentation, caused by elevated ACTH levels stimulating melanocyte activity.

Patients often present with nonspecific symptoms, including weakness, anorexia, nausea, and dizziness. In severe cases, an Addisonian crisis may occur, presenting with shock, severe hypotension, and electrolyte imbalance, which is a medical emergency.

Diagnosis is based on low serum cortisol levels with elevated ACTH, confirming primary adrenal insufficiency. The ACTH stimulation test is commonly used to assess adrenal function. Additional findings include electrolyte disturbances and possible hypoglycemia.

Management involves lifelong glucocorticoid replacement therapy (e.g., hydrocortisone) and mineralocorticoids (e.g., fludrocortisone) if needed. Early diagnosis and appropriate treatment are essential to prevent life-threatening complications.

This conceptual diagram provides a concise visual overview of causes, symptoms, and diagnostic features, making it ideal for last-minute revision.

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