Addison's disease physical examination: Difference between revisions
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=== Addisonian crisis === | === Addisonian crisis === | ||
Revision as of 19:18, 19 July 2017
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Addison's disease physical examination On the Web |
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Risk calculators and risk factors for Addison's disease physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Physical Examination
Appearance
The patient may be dehydrated and lethargic.
Vitals
Blood Pressure
Skin
- Pigmented skin and mucous membranes - darkening (hyperpigmentation) of the skin, including areas not exposed to the sun; characteristic sites are skin creases (e.g. of the hands), nipples, and the inside of the cheek (buccal mucosa), also old scars may darken.
- Vitiligo may be present.
- Absence of axillary and pubic hair in females as a result of loss of adrenal androgens.
- Pallor may be present.
Neck
- Goiter may be present.
Extremities
Neurologic
Addisonian crisis
An "Addisonian crisis" or "adrenal crisis" is a constellation of symptoms that indicate severe adrenal insufficiency. This may be the result of either previously undiagnosed Addison's disease, a disease process suddenly affecting adrenal function (such as adrenal hemorrhage), or an intercurrent problem (e.g. infection, trauma) in the setting of known Addison's disease. Additionally, this situation may develop in those on long-term oral glucocorticoids who have suddenly ceased taking their medication. It is also a concern in the setting of myxedema coma; thyroxine given in that setting without glucocorticoids may precipitate a crisis.
Untreated, an Addisonian crisis can be fatal. It is a medical emergency, usually requiring hospitalization. Characteristic physical examination findings are:[1]
Appearance
The patient may be dehydrated and confused.
Vitals
Neurologic
References
- ↑ Addison's Disease National Endocrine and Metabolic Diseases Information Service. Retrieved on 26 October, 2007.