Addison's disease history and symptoms

Addison’s disease often has an insidious onset. In many cases, the disease is only recognized when the patient presents with an acute crisis precipitated by a stressful illness or situation. Acute adrenal insufficiency should be considered in patients presenting with abdominal pain, nausea, diarrhea, hypotension, and fever. A detailed and thorough history is necessary. Specific areas of focus when obtaining a history from the patient of Addison’s disease include recent changes in diet, any signs of postural hypotension and history of cancer or other autoimmune diseases, tuberculosis or any exposure to anyone who has been diagnosed with tuberculosis.

A detailed and thorough history from the patient is necessary. Specific areas of focus when obtaining a history from the patient of Addison’s disease include:^[1]

• Recent changes in diet
  • Patients with Addison disease often crave salty foods and are often anorexic
• Irregular menstruation
  • Oligomenorrhea or amenorrhea are features of Addison disease
• Any signs of postural hypotension
• Any recent changes in weight
• History of tuberculosis or any exposure to someone with tuberculosis
• History of malignancy
• History of other autoimmune disease, such as Graves disease, Hashimoto’s thyroiditis, hypoparathyroidism, vitiligo, pernicious anemia or diabetes mellitus
• Family history of Addison’s disease or any other adrenal disorder

Addison’s disease often has an insidious onset. In many cases the disease is only recognized when the patient presents with an acute crisis precipitated by a stressful illness. Acute adrenal insufficiency should be considered in patients presenting with abdominal pain, nausea, diarrhea, hypotension and fever.^[2][3]

• Weakness
• Chronic fatigue
• Weight loss
• Anorexia
• Nausea
• Vomiting
• Diarrhea
• Intolerance of temperature extremes
• Abdominal pain
• Amenorrhea
• Craving for salty foods
• Depression
• Dizziness

Symptoms of Addisonian crisis include:

• Dizziness, generalized weakness (fatigue)
• Anorexia
• Sharp, sudden pain in the abdomen, legs, or lower back
• Severe vomiting and diarrhea
• Dehydration
• Loss of consciousness
• Hypoglycemia

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