Addison's disease

Addison's disease or primary adrenocortical deficiency results from destruction of the adrenal cortex. Glucocorticoid, mineralocorticoid and sex steroid production are all reduced.

It is a rare condition with a prevalence of 93-140 per million people and an annual incidence of 4.7-6.2 per million people in Western populations (1).

• in UK Addison’s disease affects around 1 in 10,000 individuals with an estimate of around 8400 currently diagnosed cases (2)
• according to a recent epidemiological study the incidence of Addison’s disease is on the rise (1)
• may occur at any age but commonly seen between the ages of 30-50 years (2)
• women are affected more than men (3)

Autoimmune adrenalitis accounts increasingly for the condition as tuberculosis has become less common.

The disease may remain subclinical for a long period of time (4).

Notes (5):

• primary and secondary adrenal insufficiency share many clinical features - however, they differ in that only primary adrenal insufficiency is characterized by mineralocorticoid deficiency and by hyperpigmentation

Reference:

• (1) Vaidya B, Chakera AJ, Dick C. Addison's disease. BMJ. 2009;339
• (2) Wass, J., Howlett, T., Arlt, W. et al. Diagnosing Addison's: a guide for GPs. Addison's Disease Self Help Group 2009
• (3) Barnard C, Kanani R, Friedman JN. Her tongue tipped us off. CMAJ. 2004;171(5):45
• (4) Martín Martorell P, Roep BO, Smit JW. Autoimmunity in Addison's disease. Neth J Med. 2002;60(7):269-75
• (5) Nieman LK, Turner MLC. Addison's disease. Clinics in Dermatology 2006; 24(4): 276-280