Addison disease Diagnosis and initial management

作者：O'Connell Susan^*; Siafarikas Aris

来源：Australian Family Physician, 2010, 39(11): 834-837.

• Addison disease
• diagnosis, differential
• fludrocortisone
• hydrocortisone
• patient care planning

Background
Adrenal insufficiency is a rare disease caused by either primary adrenal failure (Addison disease) or by impairment of the hypothalamic-pituitary-adrenal axis. Steroid replacement therapy normalises quality of life, however, adherence can be problematic.
Objective
This article provides information on adrenal insufficiency focusing on awareness of initial symptoms and on risk scenarios, emergency management and baseline investigations, complete investigations and long term management.
Discussion
Early recognition of adrenal insufficiency is essential to avoid associated morbidity and mortality. Initial diagnosis and decision to treat are based on history and physical examination. Appropriate management includes emergency resuscitation and steroid administration. Initial investigations can include sodium, potassium and blood glucose levels. However, complete investigations can be deferred. Specialist advice should be obtained and long term management includes a Team Care Arrangement. For patients, an emergency plan and emergency identification are essential.

• 出版日期2010-11