Addison's disease
Last reviewed 07/2023
Addison's disease or primary adrenocortical deficiency results from destruction of the adrenal cortex. Glucocorticoid, mineralocorticoid and sex steroid production are all reduced.
It is a rare condition with a prevalence of 93-140 per million people and an annual incidence of 4.7-6.2 per million people in Western populations (1).
- in UK Addison’s disease affects around 1 in 10,000 individuals with an estimate of around 8400 currently diagnosed cases (2)
- according to a recent epidemiological study the incidence of Addison’s disease is on the rise (1)
- may occur at any age but commonly seen between the ages of 30-50 years (2)
- women are affected more than men (3)
Autoimmune adrenalitis accounts increasingly for the condition as tuberculosis has become less common.
The disease may remain subclinical for a long period of time (4).Notes (5):
- primary and secondary adrenal insufficiency share many clinical features - however, they differ in that only primary adrenal insufficiency is characterized by mineralocorticoid deficiency and by hyperpigmentation
Reference:
- (1) Vaidya B, Chakera AJ, Dick C. Addison's disease. BMJ. 2009;339
- (2) Wass, J., Howlett, T., Arlt, W. et al. Diagnosing Addison's: a guide for GPs. Addison's Disease Self Help Group 2009
- (3) Barnard C, Kanani R, Friedman JN. Her tongue tipped us off. CMAJ. 2004;171(5):45
- (4) Martín Martorell P, Roep BO, Smit JW. Autoimmunity in Addison's disease. Neth J Med. 2002;60(7):269-75
- (5) Nieman LK, Turner MLC. Addison's disease. Clinics in Dermatology 2006; 24(4): 276-280