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Adrenal gland and paraganglia

Adrenal insufficiency

Addison’s disease

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 6 February 2013, last major update February 2005
Copyright: (c) 2002-2013, PathologyOutlines.com, Inc.


● 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 don’t 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

Virtual slides

Addison’s disease

End of Adrenal gland and paraganglia > Adrenal insufficiency > Addison’s disease

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