Adrenal gland and paraganglia
Adrenal insufficiency
Addison disease

Author: Nat Pernick, M.D. (see Authors page)

Revised: 13 August 2018, last major update February 2005

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Addison disease [title]
Cite this page: Pernick, N. Addison disease. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/adrenaladdisons.html. Accessed September 26th, 2018.
Definition / general
  • Also called primary chronic adrenal insufficiency
  • Affects 3 - 6 individuals per 100,000 population
  • No symptoms until 90% of cortex is compromised
  • More common in white women
  • Causes: autoimmune disorders, infections (Histoplasma, Coccidiodes, tuberculosis), space occupying lesions (metastases, lymphomas), hemorrhage, amyloid, sarcoid or hemochromatosis
  • Symptoms: progressive weakness, easy fatigability, anorexia, weight loss, depression, irritability, menstrual abnormalities, GI disturbances, hyperpigmentation (primary adrenal disease causes elevated ACTH, which stimulates melanocytes at sun exposed areas and pressure points), small heart (due to chronic hypovolemia) and hypotension; infections may precipitate an acute crisis
  • Laboratory: elevated ACTH levels, low cortisol levels that do not respond to exogenous ACTH (since adrenal gland is damaged), hyponatremia, hypoglycemia, hyperkalemia and occasionally hypercalcemia
Gross description
  • Irregularly shrunken glands, may be hard to find