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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.