Addison's disease physical examination: Difference between revisions

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Revision as of 19:20, 19 July 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

The patient may be dehydrated and lethargic.

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.

@@ Line 29: / Line 29: @@
 * [[Seizures]] may be present.
-=== 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 [[glucocorticoid]]s who have suddenly ceased taking their medication.  It is also a concern in the setting of [[myxedema coma]]; [[thyroxine]] given in that setting without [[glucocorticoid]]s may precipitate a crisis.
-Untreated, an Addisonian crisis can be fatal. It is a [[medical emergency]], usually requiring hospitalization. Characteristic physical examination findings are:<ref>[http://www.endocrine.niddk.nih.gov/pubs/addison/addison.htm#symptoms Addison's Disease] National Endocrine and Metabolic Diseases Information Service. Retrieved on 26 October, 2007.</ref>
-====Appearance====
-The patient may be [[dehydrated]] and confused.
-====Vitals====
-* [[Hypotension|Low blood pressure]]
-====Neurologic====
-* [[Confusion]], [[psychosis]]
-* [[Seizure|Convulsions]]
 ==References==