PREFERRED PRACTICE PATTERNS4
A 25-year-old female referred with significant sarcopenia and a BMI of 16. Her gait is unstable and she demonstrates coordination deficits. She is mildly short of breath on exertion. She describes little interest in food, but does have self-described craving for potato chips at times. Of late, she is too tired to exercise and she thinks it is because she is depressed. Her history reveals that she menstruates infrequently over the past year and that her skin tone has changed.
Clinical features of Addison disease. Note the hyperpigmentation in areas of increased friction including (A) palmar creases, (B) dorsal foot, (C) nipples and axillary region, and (D) patchy hyperpigmentation of the oral mucosa. (From Longo DL, Fauci A, Kasper D, et al., eds. Harrison’s Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill; 2012.)
Insufficient production or release of glucocorticoids (cortisol),1 androgens, and mineralocorticoids from the adrenal glands
These hormones play a role in
Conversion of food to energy
Response to stress
Maintaining sodium–potassium balance for blood pressure regulation and production of androgens in males and women, involved in maintaining libido
May be insidious onset or sudden onset as in Addisonian crisis
May cause pathology in multiple organ systems or be caused by pathology in other organ systems
Confirmation of suspected disease through blood testing
Addison disease A. Hyperpigmentation representing an ...
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