Features and treatment of Addison's disease
Common symptoms and signs | Laboratory features |
Anorexia | Hyponatraemia |
Weakness | Hyperkalaemia |
Fatigue | Uraemia |
Nausea and vomiting | Metabolic acidosis |
Postural dizziness | Hypercalcaemia |
Weight loss | Normochromic normocytic anaemia |
Hypotension | Eosinophilia |
Pigmentation | Lymphocytosis |
Emergency treatment | Maintenance therapy |
Measure plasma cortisol | Primary adrenal failure: |
Intravenous hydrocortisone 100 mg with 0.9% saline | Hydrocortisone 15–20 mg am, 5–10 mg at 4 pm or |
Hydrocortisone 15–20 mg am, 5 mg at noon, 5 mg at 4 pm | |
and | |
Fludrocortisone 0.05–2 mg am | |
Secondary adrenal failure: | |
Hydrocortisone as above |