Addison's Disease Essay Example | Topics and Well Written Essays - 2500 words

Addison's Disease - Essay Example Autoimmunity remains the chief cause of Addison’s disease in Europe and in Africa, although the incidence rates in Africa are comparatively low. The key immunological finding in most patients is the presence of autoantibodies against cytochrome P450 21-hydroxylase, an essential enzyme in the biosynthesis of adrenal steroid hormones. Inadequate amounts of adrenal hormones present symptoms such as hypoglycemia, fatigue, vomiting, and hyperpigmentation among many others. A careful examination of morning cortisol levels and amounts of ACH aid in giving correct diagnosis for patients with Addison’s disease. The only treatment available is replacement therapy using synthetic glucocorticoids and mineralocorticoids. However, it is vital that diagnosis is made early enough to ensure that the patients start treatment on time and enjoy productive lives. Key Words: Addison’s disease; Adrenal insufficiency; Autoimmunity Introduction Addison’s disease is an endocrine an d immunological disorder that leads to adrenal insufficiency. The pituitary gland secretes excess adrenocorticotropic hormone to make up for the reduced amount of cortisol in the adrenal glands (Burk et al. 215). Autoimmune Addison’s disease occurs due to adrenal inadequacy because of immune mediated destruction of the adrenal cortex (Rottembourg et al. 309). In 1849, Dr. Addison illustrated a form of anemia that had been overlooked. This ailment was common in men between the ages of 20 and 60. It was characterized by a slow onset and took several weeks or even months to display alarming symptoms such as immense fatigue, paleness, and mental and physical incapacitation (Bishop 35). A postmortem of three cases revealed a diseased condition of the suprarenal capsules, which Dr. Addison believed was not a happenstance. He, therefore, decided that the suprarenal capsules were indirectly or indirectly involved in the events that led to the diseased condition. In 1855, Dr. Addison published a monograph addressing the consequences of disease on the suprarenal capsules. It sought to establish the actual functions and impact of these cells. The monograph associated the similarities of the renal suprarenal capsules with the spleen, thyroid body, and thymus to the embellishment of blood (Bishop 36). He further described the progression and key symptoms of the problem and explains that all cases defied curative endeavors and ended lethally. It is worth noting that during that time the functions of the supra-renal capsules were unknown. Later on in 1856, Trousseau called the condition â€Å"La Maladie d’ Addison† (Bishop 37). Charles Edouard Brown-Sequard collected a number of rabbits, cats, and dogs and deprived them of their adrenals. He thought that if the animals did then they would have died because of Addison’s disease. A pressor substance was discovered in the adrenal medulla in 1894 after which Takamine and Aldrich separately isolated th e crystalline form of adrenaline in 1091. Having been synthesized in 1904, adrenaline became the first hormone to be isolated chemically, characterized, and synthesized (Bishop 38). It was then discovered that cortical extracts contained substances that preserved life. The clinical syndrome as described by Dr. Addison was later called Addison’s disease following his relation of adrenal insufficiency to the symptoms. Addison’s disease is prevalent in Western countries compared to African countries as established by Ross et al. during a cohort study of South Africans (292). Etiology There are several causes of Addison’s disease such as marred steroidogenesis, adrenal dysgenesis, and diseases that lead to the destruction of the adrenal cells (Burk et al. 215). Autoimmune destruction of t