Cardinal features of addisons disease

Following are the cardinal features of Addison s disease

Commonly the patient is female and suffers from :

• Asthenia,hypotenstion.hyperpigmentation are the major manifestations

The minor manifestations are

• Anorexia, malaise, weight loss.
• Decreased body hairs
• Hyperkalaemia.
• Hvpoglycaemia
• Nausea, vomiting.
• Chronic fatigue syndrome.
• Acute adrenal crisis.

Pigmentation in addison's disease .

• Pigmentation in addisons disease is due to increased pituitary MSH andACTH secretions
• Initially there is tanning after exposure to the sun.
• Later there is tanning noticed pressure points (elbow).
• Normally  pigmented areas like areola ,knuckles palmar creases and scars become more pigmented
• Mucous membrane pigmentation can occur (genitals and oral cavity)
• There may be areas of vililigo

Differentiation between primary and secondary adrenocortical insufficiency

In primary (Addison s disease) cases, there are features of.

• Absence of hypothyroidism and hypogonadism
• High plasma ACTH level.

In secondary hypofunction, there are :

• Absence of pigmentation.
• Presence of hypothyroidism and hypogonadism
• Low plasma ACTH level.