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Addison’s disease (also Addison disease, chronic adrenal insufficiency, hypocortisolism, and hypoadrenalism) is a rare, chronic endocrine system disorder in which the adrenal glands do not produce sufficient steroid hormones (glucocorticoids and mineralocorticoids). It is characterised by a number of relatively nonspecific symptoms, such as abdominal pain and weakness, but under certain circumstances, these may progress to Addisonian crisis, a severe illness which may include very low blood pressure and coma. An adrenal crisis often occurs if the body is subjected to stress, such as an accident, injury, surgery, severe infection or illness; death may quickly follow. The condition arises from problems with the adrenal gland, ''primary adrenal insufficiency'', and can be caused by damage by the body's own immune system, certain infections, or various rarer causes. Addison's disease is also known as chronic primary adrenocortical insufficiency, to distinguish it from acute primary adrenocortical insufficiency, most often caused by Waterhouse–Friderichsen syndrome. Addison's disease should also be distinguished from secondary and tertiary adrenal insufficiency, which are caused by deficiency of ACTH (produced by the pituitary gland) and CRH (produced by the hypothalamus), respectively. Despite this distinction, Addisonian crises can happen in all forms of adrenal insufficiency. Addison's disease and other forms of hypoadrenalism are generally diagnosed via blood tests and medical imaging.〔 Treatment involves replacing the absent hormones (oral hydrocortisone and fludrocortisone).〔 Lifelong, continuous steroid replacement therapy is required, with regular follow-up treatment and monitoring for other health problems.〔 Addison’s disease is named after Thomas Addison, a graduate of the University of Edinburgh Medical School who first described the condition in 1849. The adjective "Addisonian" is used to describe features of the condition, as well as people with Addison’s disease. ==Signs and symptoms== The symptoms of Addison's disease develop gradually and may become established before they are recognized. The most common ones are fatigue; lightheadedness upon standing or difficulty standing; muscle weakness; fever; weight loss; anxiety; nausea; vomiting; diarrhea; headache; sweating; changes in mood or personality; and joint and muscle pains. Some patients have cravings for salt or salty foods due to the loss of sodium through their urine.〔 Hyperpigmentation of the skin may be seen, particularly when the patient lives in a sunny area, as well as darkening of the palmar crease, sites of friction, recent scars, the vermilion border of the lips, and genital skin. This is not encountered in secondary and tertiary hypoadrenalism. On physical examination, the following clinical signs may be noticed:〔 * Low blood pressure with or without orthostatic hypotension (blood pressure that decreases with standing) * Darkening (hyperpigmentation) of the skin, including areas not exposed to the sun. Characteristic sites of darkening are skin creases (e.g. of the hands), nipple, and the inside of the cheek (buccal mucosa); also, old scars may darken. This occurs because melanocyte-stimulating hormone (MSH) and adrenocorticotropic hormone (ACTH) share the same precursor molecule, pro-opiomelanocortin (POMC). After production in the anterior pituitary gland, POMC gets cleaved into gamma-MSH, ACTH and beta-lipotropin. The subunit ACTH undergoes further cleavage to produce alpha-MSH, the most important MSH for skin pigmentation. In secondary and tertiary forms of adrenal insufficiency, skin darkening does not occur, as ACTH is not overproduced. Addison's disease is associated with the development of other autoimmune diseases, such as type I diabetes, thyroid disease (Hashimoto's thyroiditis), and vitiligo. The presence of Addison's in addition to one of these is called autoimmune polyendocrine syndrome. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Addison's disease」の詳細全文を読む スポンサード リンク
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