Addison’s disease in Children

addison’s disease is when the adrenal glands don’t make enough of two steroid hormones. the hormones are cortisol and aldosterone. cortisol controls the body’s metabolism, blocks inflammatory reactions, and effects the immune system. Aldosterone manages sodium and potassium levels. the adrenal glands sit on top of the kidney. Addison’s diseases is fairly rare and may first appear at any age .

What causes Addison’s disease in a child?

the most common cause of addison’s disease is damage to the adrenal glands caused by an autoimmune disease.

other case of addison’s disease are caused by the damage to the glands by any off these

• Cancer
• Infection
• An autoimmune problem
• A rare genetic disease

in rare cases, Addison’s disease is passed down in a family. Other causes of low corticosteroids can include:

• Use of corticosteroid medicine: This includes prednisone. the medicines lower the amount of natural corticosteroids made by the adrenal glands.
• Use of some medicines to treat fungal infection: These medicines may stop corticosteroids beaing made in the adrenal glands.

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What at risk ?

A child is at risk for Addison’s disease if he or she has any off these

• An autoimmune disease
• Cancer
• Infection such as tuberculosis
• family history of the disease
• History of using corticosteroid medicines
• History of using anti-fungal medicines

Symptoms of addison’s disease in a child

mild symptoms may only occur when a child us physical stress. symptoms may include:

• Muscle Weakness
• Fatigue
• fast pulse
• Dizziness
• Dark skin, first seen on hands and face
• Black freckles
• Bluish-black color around the nipples, mouth , rectum, scrotum , or vagina
• weight loss
• dehydration
• loss of appetite
• Intense salt craving
• Muscle aches
• Nausea
• Vomiting
• Diarrhea
• Intolerance to clod

the symptoms of Addison’s Disease can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

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Addison’s disease diagnosis

symptoms for Addison’s Disease often come on slowly. In addition to a complete medical history and physical examination, diagnostic procedures for Addison’s Disease may include:

• Laboratory blood test: to measure levels of corticosteroid hormone (cortisol) and the pituitary hormone ACTH , which regulates adrenal gland function.
• An ACTH stimulation test : to assess adrenal gland function
• measurement of electrolytes : in the blood

Based on the results of these tests, your child’s doctor will be able to definitively diagnose whether your child has Addison’s disease.

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Addison’s disease treatment

the goal of treatment is to replace the hormones and to relieve the symptoms. Addison’s disease can be life-threatening. Because of this treatment often starts right away with corticosteroid medicine may be taken by mouth. Or it may be given by IV. It depends on how sick your child is. In most cases, corticosteroid medicine must be taken for life . Treatment may also include a medicine that helps mange the body’s levels of sodium and potassium.

Possible complications

If untreated , Addison’s disease may lead to :

• Severe abdominal pain
• Extreme weakness
• Low blood pressure
• Shock from dehydration

severe complication are most likely to occur when the child is under physical stress. Lack off adrenal hormones may also cause:

• High blood levels of potassium , which affect the water and sodium levels in the body
• Extreme sensitivity to the hormone insulin, which may lead to low sugar levels

Helping a child live with Addison’s disease

Addison’s disease is a life-long condition. It needs lifetime treatment. stressful events such as surgery, infection, or injury can cause sever symptoms of Addison’s . this is because corticosteroids help the body fight infection and keep healthcare provider if your child’s need surgery. get medical care for your child away if he or she :

• Has vomiting or diarrhea
• Has any other infection or illness

Your child should wear a medical alert bracelet or necklace. Work with your child’s healthcare provider to help and mange your child’s condition.

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When to call for help

Understanding when to seek medical help for Addison’s disease symptoms or an adrenal crisis is essential for managing adrenal insufficiency and avoiding life-threatening complications. For non-urgent signs like chronic fatigue, muscle weakness, unexplained weight loss, abdominal pain, nausea, low blood pressure leading to dizziness, salt cravings, or skin hyperpigmentation (darker patches on skin folds, scars, or mucous membranes), schedule a prompt appointment with your healthcare provider for diagnostic tests such as cortisol level checks or ACTH stimulation to initiate hormone replacement therapy with medications like hydrocortisone and fludrocortisone.

However, if emergency symptoms of an Addisonian crisis appear—such as severe abdominal, back, or leg pain, persistent vomiting and diarrhea causing dehydration, confusion, irritability, rapid heart rate, fever above 37.5°C,

severe drowsiness, seizures, pale clammy skin, or loss of consciousness—call 999 or your local emergency number immediately, as this can be triggered by infections, injuries, surgery, or stress and requires urgent intravenous steroids and fluids to prevent shock, coma, or death. Individuals diagnosed with Addison’s disease should adhere to sick day rules, including doubling oral steroid doses during mild illness, self-injecting 100mg hydrocortisone if unable to retain pills, and seeking hospital care for ongoing vomiting or high fever, while always carrying a steroid emergency card, medical alert bracelet, and injection kit for quick response in adrenal crisis situations. Early awareness and intervention are key to maintaining health with this condition.

Determining when to seek help is pivotal: for non-emergency symptoms that persist or worsen gradually, consult a general practitioner or endocrinologist promptly, as early diagnosis through blood tests (measuring cortisol, ACTH, electrolytes, and possibly antibodies) and imaging (CT or MRI) can initiate lifelong treatment and avert crises. If you always feel exhausted, weak, or are losing weight unexplainedly, ask your provider about adrenal insufficiency testing. For suspected adrenal crisis, act immediately by calling emergency services (e.g., 999 in the UK or 911 in the US), using phrases like “adrenal crisis” and “steroid-dependent” to alert responders. If diagnosed, self-administer an emergency 100mg hydrocortisone injection intramuscularly into the thigh or arm if trained, then seek hospital care for IV fluids, additional steroids, and monitoring of electrolytes and blood sugar. Treatment for Addison’s involves daily oral steroids—hydrocortisone (typically 15-25mg divided into 2-3 doses mimicking natural cortisol rhythm), prednisolone, or dexamethasone for cortisol replacement, and fludrocortisone (0.05-0.2mg daily) for aldosterone—adjusted based on symptoms, weight, and blood pressure. During minor illnesses, double or triple glucocorticoid doses; for vomiting, use injections and hospitalize. Preventive measures include wearing medical alert jewelry, carrying a steroid card, informing healthcare providers before procedures, staying hydrated, treating infections early, and having an emergency plan with family or friends trained in injections. With proper management, individuals can lead normal lives, though regular endocrinologist check-ups (every 6-12 months) are essential to monitor hormone levels, associated conditions like thyroid issues or diabetes, and overall health. Pregnancy requires specialist oversight to adjust doses and mitigate risks like miscarriage.

Patient support groups emphasize education on self-management, such as watching instructional videos for injections and preparing hospital bags with guidelines. While autoimmune causes aren’t curable, treating underlying infections (e.g., TB with antibiotics) can help in some cases. Overall, awareness of triggers and adherence to therapy significantly reduce crisis risks, enabling a full, active life

key points about Addison’s disease in a child

• Addison’s disease is when the adrenal glands don’t make enough cortisol and aldosterone
• The most common cause of Addison’s disease is damage to the adrenal glands caused by an autoimmune disease. Medicine can also cause the adrenal glands to not make enough cortisol.
• mild symptoms of Addison’s disease may only appear when a child is under physical stress . Symptoms may include muscle weakness , fatigue , and dizziness.
• Addison’s disease can be life threatening . Because of this , treatment often start right away with corticosteroid medicine. in most cases, corticosteroid medicine must be taken for life .Treatment may also include a medicine that helps manage the body’s levels of sodium and potassium.
• if left untreated Addison’s disease may lead to severe weakness , kidney failure , and shock.
• Stressful events such as surgery , infection , or injury can cause sever symptoms of Addison’s disease .