Addison's disease is a severe or total deficiency of the hormones made in the adrenal cortex, caused by a destruction of the adrenal cortex.
The inner part of the adrenal (the medulla) produces epinephrine (adrenaline) which is produced at times of stress and helps the body respond to "fight or flight" situations.
The outer portion of the adrenal, the cortex, makes two important steroid hormones, cortisol and aldosterone. Cortisol production is regulated by adrenocorticotrophic hormone (ACTH), made in the pituitary gland. Aldosterone regulates salt and water levels which affects blood volume and blood pressure.
When Dr. Thomas Addison first described this disease in London in 1855, the most common cause was tuberculosis.
Currently, the major cause of Addison's disease results from an auto-immune reaction in which the body's immune system erroneously makes antibodies against the cells of the adrenal cortex and slowly destroys them. That process takes months to years.
There are also several less common causes of Addison's disease: other chronic infections besides tuberculosis, especially certain fungal infections, invasion of the adrenal by cancer cells that have spread from another part of the body, especially the breast; CMV virus in association with AIDS; rarely, hemorrhage into the adrenals during shock; and the surgical removal of both adrenals.
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