How to Treat Addison’s disease in Babies

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How to Treat Addison's disease in Babies

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Addison’s disease occurs when the adrenal glands do not produce enough of the hormones cortisol and aldosterone (both corticosteroids).

It is also known as chronic adrenal insufficiency, or hypocortisolism.

It can make babies feel weak and tired, but it can also be effectively treated with replacement steroids.

Types of Addison’s disease

There are two main types of Addison’s disease.

Primary adrenal insufficiency: the adrenal glands do not produce enough cortisol and aldosterone

Secondary adrenal insufficiency: the pituitary gland in the brain does not release enough of the hormone that stimulates the adrenal gland to release cortisol.

What causes Addison’s disease?

Addison’s disease may be caused by anything that damages the adrenal glands, such as:

autoimmune disease where the immune system attacks some of the bodies own tissues)

Infection of the adrenal glands

blood loss, blood thinning drugs

cancer in the adrenal glands

bleeding in the adrenal glands

tuberculosis

conditions such as type 1 diabetes

genetic defects
disease in the pituitary glands

If you suddenly stop taking corticosteroids for conditions like asthma or arthritis.

It can also be caused by anything that affects the pituitary gland in the brain, such as a tumour.

Addison’s disease symptoms

The symptoms of Addison’s disease start gradually and can include:

  • a darkening of the skin, with or without sun exposure
  • weight loss
  • low blood pressure and sometimes fainting
  • fatigue and muscle weakness
  • loss of appetite
  • salt cravings
  • low blood sugar
  • abdominal pain
  • muscle or joint pains
  • poor growth in children
  • nausea, vomiting and diarrhoea
  • irritability and depression
  • Loss of hair

What is an Addisonian crisis?

An Addisonian crisis can occur when an accident or illness causes symptoms to worsen.

These can include sudden pain in the lower back, legs or abdomen, low blood pressure, severe vomiting and diarrhoea and loss of consciousness.

An untreated Addisonian crisis can be fatal.

In the case of accident, illness, vomiting or diarrhoea people with Addison’s disease must have their medication adjusted according to their specific needs.

Addison’s disease diagnosis

Addison’s disease can be diagnosed in a variety of ways, including:

  • blood tests to determine hormone levels
  • a blood sugar test
  • X-ray, MRI or CT scan to look at the structure of the adrenal or pituitary glands
  • medical and family history.

Addison’s disease treatment

Treatment for Addison’s disease requires life-long steroid replacement therapy.

This includes

  • corticosteroid tablets, corticosteroid injections, androgen replacement and sometimes increased sodium (salt) intake.
  • Babies with Addison’s disease are advised to wear an identification disc or bracelet noting treatment in an emergency.

What are the symptoms of Addison’s disease?

Symptoms of mild Addison’s disease may only be apparent when your child is under physical stress.

While each child may experience symptoms differently, some of the most common symptoms include:

  • weakness
  • fatigue
  • dizziness
  • rapid pulse
  • darkening of the skin (first noted on hands and face)
  • black freckles
  • bluish-black discoloration around the nipples, mouth, rectum, scrotum or vagina
  • weight loss
  • dehydration
  • loss of appetite
  • intense salt craving
  • muscle aches
  • nausea
  • vomiting
  • diarrhea
  • intolerance to cold

What causes Addison’s disease?

Addison’s disease is most often caused by the destruction of the adrenal gland due to an autoimmune response.

Some cases are caused by the destruction of the adrenal glands through cancer, infection or other disease.

Other causes may include:

use of corticosteroids (such as prednisone) to treat another condition, such as asthma, inflammatory bowel disease or certain types of cancer

use of certain medications to treat fungal infections, which may block production of corticosteroids in the adrenal glands

In rare cases, Addison’s disease is inherited as an X-linked trait, meaning that the gene responsible for the condition is located on the X chromosome and passed down from a mother to her child.

In this form, symptoms typically begin in childhood or adolescence.

Boston Children’s Hospital has been named the #1 children’s hospital in the nation by U.S.

News and World Report for the fifth year in a row! It’s an honor that we could not have achieved without you.

On behalf of every member of our Boston Children’s team, thank you for inspiring us to be bolder, dream bigger, and make the impossible possible for our patients and families.

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