Endocrinolgy : Addison"s Disease : Investigations & Complications

Addison"s Disease : Investigations and Complications.

The investigations for Addison"s Disease include the following :

Blood test :

Tests are taken to measure blood levels of sodium, potassium, cortisol and adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce its hormones.

A blood test can also measure antibodies associated with autoimmune Addison's disease.

ACTH stimulation test :

ACTH signals body”s  adrenal glands to produce cortisol. This test measures the level of cortisol in the blood before and after an injection of synthetic ACTH.

Insulin-induced hypoglycemia test :

This test is done if a patient has suspected adrenal insufficiency as a result of pituitary disease (secondary adrenal insufficiency).

The test involves checking your blood sugar (blood glucose) and cortisol levels after an injection of insulin.

In healthy people, glucose levels fall and cortisol levels increase.

In certain situations doctors may do alternative tests for secondary adrenal insufficiency, such as a low-dose ACTH stimulation test, prolonged ACTH stimulation test or glucagon stimulation test.

Imaging test :

A computerized tomography (CT) scan of abdomen to check the size of adrenal glands and look for other abnormalities.

Also , an MRI scan of  pituitary gland should be done if testing indicates a likelihood of secondary adrenal insufficiency.

Complications :

Addisonian crisis :

If someone has  untreated Addison's disease, they may develop an Addisonian crisis as a result of physical stress, such as an injury, infection or illness.

Normally, the adrenal glands produce two to three times the usual amount of cortisol in response to physical stress.

With adrenal insufficiency, the inability to increase cortisol production with stress can lead to an addisonian crisis.

An addisonian crisis is a life-threatening situation that results in low blood pressure, low blood levels of sugar and high blood levels of potasium & it requires immediate medical care.

People with Addison's disease commonly have associated autoimmune diseases.