A review on Understanding Addison's Disease: From Early Symptoms to Accurate Diagnosis

Addison’s disease, a rare endocrine disorder affecting approximately 1 in 100,000 individuals, is characterized by adrenal insufficiency due to adrenal cortex dysfunction. Initially described by Thomas Addison in 1855, the disease’s etiology has shifted from infectious causes, such as tuberculosis, to autoimmune mechanisms, especially in industrialized countries. In children, congenital adrenal hyperplasia (CAH) is a common cause, while autoimmune destruction dominates in adults. Autoimmune adrenal insufficiency is associated with various other autoimmune disorders, often manifesting as polyglandular syndromes. The disease leads to insufficient cortisol and aldosterone production, resulting in symptoms like fatigue, hyperpigmentation, hypotension, gastrointestinal issues, and salt cravings. Diagnosis involves measuring serum cortisol, ACTH levels, and performing the cosyntropin stimulation test. Treatment requires lifelong hormone replacement with glucocorticoids (prednisone or hydrocortisone) and mineralocorticoids (fludrocortisone). Despite advances in research, the condition remains incurable, with management focusing on symptom control and preventing adrenal crises. Moreover, patients require ongoing monitoring for comorbid autoimmune conditions. This review explores the pathophysiology, diagnosis, and multidisciplinary management of Addison’s disease, emphasizing the significance of oral manifestations and the need for continuous care.