Adrenal Insufficiency (Primary: Addisons)

Etiology

  • Problem at level of adrenal gland, including: autoimmune destruction → assoc w/dm 1, celiac dz
  • Adrenal hemorrhage/infarct
  • Adrenal infection → TB, HIV
  • Adrenal infiltration w/tumor
  • Meds (e.g. Ketoconazole)

Symptoms

  • Fever
  • Salt craving
  • Sub-acute feeling poorly in general, fatigue, weakness
  • Abdominal pain, nausea, vomiting
  • Weight loss, muscle aches
  • Orthostatic sx/dizziness
  • Decreased libido in women

Physical Exam Findings

  • Fever
  • Hypotension: frankly low BP and/or orthostatic
  • Loss of axillary & pubic hair in women
  • Sometimes darkening of mucous membranes, skin folds, & pressure points

Tests