- pigmentation usually generalized but more prominent over sun-exposed area such as the face,extensor surfaces,elbows,knees,knuckles and scars (which formed after the onset of disease)
- may also affect the palmar crease,mucous membrane,nail beds,vaginal and perianal mucosa
Addison disease
Case 1 : Addison disease
Case 1 : Addison disease
A 12-year-old girl presented with vague abdominal discomfort for 6 months. She had noticed occasional diarrhoea but had not passed any blood. She admitted to weight loss (6kg) and anorexia. On examination, she was obviously pigmented, although she thought this was sun induced; however, her buccal mucosa and gums were also brown. There were no other physical signs.
She had a low cortisol level and her response to the adrenocorticotrophic hormone in a Synacthen test was poor. A diagnosis of adrenal cortical failure was made. X-ray of her abdomen showed no calcified areas in either adrenal gland, and her serum contained antibodies to adrenal cortex, consistent with a diagnosis of Addison's disease due to autoimmune adrenalitis. Her serum also contained antibodies to pancreatic islet cells and thyroid microsomes. In view of her young age at presentation and these serum antibodies, she will be followed at yearly intervals to see if she develops other autoimmune endocrinopathies.
from: www.immunologyclinic.com
Adrenal gland
- found at the level of T12
- divided into 2 area : adrenal cortex and adrenal medulla
- form the core of adrenal gland
- made up by chromaffin cells that produce
- catecholamine : adrenaline and noradrenaline
- dopamine
- form the outer layer of adrenal gland
- consist of 3 layers : zona glomerulosa ,zona fasciculata, zona reticularis
- zona glomerulosa :
- the outermost layer of the cortex
- produce mineralocorticoids mainly aldosterone
- zona fasciculata:
- middle layer
- produce glucocorticoids mainly cortisol
- zona reticularis
- innermost layer
- produce small number of androgens
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The Chosen One
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