Primary Adrenal Insufficiency ( Pai ) Essay

Some symptoms that can also occur in some patients are nausea, vomiting, and diarrhea. The previously mentioned symptoms are fairly common with many different disorders however some of the most defining symptoms of Addison’s disease are low blood pressure that drops when standing, and skin changes or hyperpigmentation that is most visible on areas of the body such as scars, knees, elbows, knuckles, lips, and skin folds. Patients can also suffer from depression, irritability, and a craving for salt, and amenorrhea in female patients.

Addison 's disease is a disorder that occurs when a person 's adrenal glands produce insufficient amounts of certain hormones. When Addison 's diseased was first discovered the endocrine system was not yet completely understood therefore the disease itself was for the most part fatal. After years of research and medical breakthroughs Addison 's disease is now a disease in which someone can live a normal life as long as a daily dose of replacement

Alongside with organs, bones, and tissues, the human body also functions through hormones. Some of these hormones are produced by the adrenal glands which are located right above the kidneys. Adrenal glands produce hormones that give vital instructions to almost every organ and every tissue in your body. When someone’s adrenal glands do not produce enough amounts of certain hormones such as cortisol and aldosterone, this often leads to Addison’s Disease.

Addison Disease defined as a rare condition that affects the adrenal gland both in men and women alike. Addison Disease occurs when the body does not make enough cortisol or even sometimes aldosterone due to the autoimmune system attacking the adrenal glands. Cortisol needed to regulate the bodies response to stress. Aldosterone needed to help the kidneys regulate the amount of salt and water in the body to keep blood pressure under control, to low aldosterone causes hypotension. Infections such as Tuberculosis, HIV, Fungal Infections (and sometimes even Bacterial Infections), and Cancer cells can harm the adrenal gland.

The disease is a life-long illness that needs to be maintained everyday based on the individual’s lifestyle. Our own personal hormones fluctuate on a daily basis to keep our bodies strong and healthy. So, without the adrenal glands producing the correct amount of hormones, doctors can prescribe medication that mimics them like hydrocortisone. The dose will change based on if the patient experiences illnesses such as the common cold, flu, or other types of viral infections. The body’s innate defenses cannot fight off airborne/pathogens as efficiently as they should (Erickson et al, 2000). So the patient can take an extra dose until the symptoms are relieved. Stress plays a big role in regulating the amount of hydrocortisone taken. Patients under high amounts of stress will often require another dose. Prednisone is another drug that is prescribed as well. Prednisone is a steroid that helps Addison’s patients fight off all the nasty bacteria that we encounter in our day to day lives (Pozzilli, Lenzi, & Clarke, 2013). If the patient does not take the prescribed doses or is thrown off balance due to daily activity, it can potentially be fatal. The patient can experience an Addisonian crisis, which is fast acting and very deadly (Renz,

Congenital adrenal hyperplasia is a well-known autosomal recessive disorder and the vast majority, approximately 95%, of cases are due to a deficiency of 21-alpha-hydroxylase. The other common type of CAH is caused by a deficiency of 11-beta-hydroxylase. In both types of the disorder, the adrenal gland is unable to produce sufficient amounts of cortisol and aldosterone. CAH is estimated to manifest in 1 of every 15,000 live births. In the United States, the prevalence of the disorder is lower in African-American children in comparison to Caucasians. Moreover, the decreased synthesis of cortisol results in diminished negative feedback of adrenocorticotropic hormone (ATCH) and over-secretion of ACTH. This pathological increase of ACTH in an attempt to increase serum cortisol levels is prevented because of the lack of appropriate enzymes and actually results in increased androgen

Adrenoleukodystrophy, or ALD, is a deadly genetic disease that affects 1 in 35, 000 people. It most severely affects boys and men. It knows no racial, ethnic, or geographic barriers. ALD is currently not curable, but doctors can help slow progression. Symptoms of ALD include weak muscles, poor appetite, weight loss, paralysis, seizures, developmental delay , mental retardation , and vision and hearing impairment. Treatment methods differ depending on the type of ALD one has. Steroids can be used to treat Addison’s disease. Other treatments include: physical therapy to loosen muscles, medication to relieve seizures, or taking Lorenzo’s oil to help lower elevated VLCFA levels. This can harm one’s spinal cord, brain, adrenal glands, and testes.

Cortisol is a naturally occurring glucocorticoid. It stimulates gluconeogenesis and the breakdown of fat and protein antagonizing some actions of insulin. It helps maintain the extracellular fluid volume and normal blood pressure. Circulating cortisol is bound to cortisol binding globulin and albumin. Cushing’s syndrome occurs as a result of excess of circulating cortisol.

Idiopathic Addison disease is an autoimmune disorder that causes destruction of the adrenal cortexes, which in turn causes inadequate production of corticosteroids (Munir & Waseem, 2017). The patient will have increased levels of ACTH, but low cortisol and aldosterone levels (Jones, Brashers, & Huether, 2010). Clinical manifestations include electrolyte imbalances,

Cushing’s syndrome(CS) results from prolonged exposure to excess free glucocorticoids. Around 10-15 per million people are affected by CS every year(1). Most patients with CS have an Adrenocorticotrophic(ACTH)- secreting pituitary adenoma, which is otherwise known as Cushing’s disease. Other causes of CS include adrenal tumours, ectopic ACTH-secreting tumours and exogenous steroid use. Except for exogenous steroid use, the other mentioned causes of CS can all be caused by genetic mutations. Currently, very little is known about the prevalence of genetic mutations in CS. This essay will discuss the key genetic mutations that cause CS and explore the advantages of identifying the mutations with regards to clinical management of CS.

*Congenital adrenal hyperplasia, androgen-secreting tumours, Cushing's syndrome, 21-hydroxylase-deficient non-classic adrenal hyperplasia, androgenic/anabolic drug use or abuse, syndromes of severe insulin resistance, thyroid dysfunction, hyperprolactinaemia.

Adrenoleukodystrophy (ALD) is known for its horrific defects in children mainly boys. This disease affects the adrenal glands and white matter of the brain (http://www.x-ald.nl/clinical-diagnosis/facts-on-x-linked-adrenoleukodystrophy/ ). ALD causes the loss of the myelin sheath around nerve cells-demyelination which is responsible for brain degeneration. Myelin causes the insulation and functioning of nerve cells therefore without myelin the nerve cells do not function normally by not sending impulse. Most unfortunately, the myelin does not repair itself; overtime the disease worsens and eventually leads to death. The most common symptoms of this disease are change of behaviour, hyperactivity, loss of memory, weakening of the muscles, difficulty

Hormonal imbalances. People who have chronic fatigue syndrome also sometimes experience abnormal blood levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands. But the significance of these abnormalities is still

As shown in Table 1 Cushing’s Disease is the most common cause of CS. This disease most commonly develops due to an ACTH producing pituitary tumor9. The increase in ACTH production leads to an increased ACTH concentration in plasma causing bilateral adrenocortical hyperplasia and hypersecretion of cortisol from the adrenal cortex. Due to the feedback mechanism as shown in Figure 1 a chronic increase in cortisol leads to the suppression of CRH and ACTH secretion.

Adrenal insufficiency is still a significant challenge for both patients and their physicians, but also scientists and researchers. In the past decade long-term studies with adequate follow-up have shown surge in mortality and morbidity,