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
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.
| Category | Non-Emergency Symptoms | Emergency (Adrenal Crisis) Symptoms | Recommended Action |
|---|---|---|---|
| General Fatigue & Weakness | Chronic tiredness, muscle weakness, joint pain | Extreme weakness, muscle spasms, severe drowsiness | Consult doctor for non-emergency; call emergency for crisis |
| Gastrointestinal | Loss of appetite, weight loss, nausea, abdominal pain, salt cravings | Severe vomiting, diarrhea, dehydration | Schedule appointment; seek immediate IV fluids if severe |
| Cardiovascular & Neurological | Low blood pressure (dizziness on standing), irritability, depression | Rapid heart rate, confusion, headache, seizures, loss of consciousness | Monitor blood pressure; call 999/911 urgently |
| Skin & Other | Hyperpigmentation, increased thirst, irregular periods | Pale clammy skin, sweating, fever | Early testing; hospital treatment with steroids |
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 Addison’s disease
- 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 .
Addison’s disease is a rare hormonal disorder where the adrenal glands don’t produce enough cortisol and aldosterone. These hormones help regulate blood pressure, metabolism, stress response, and electrolyte balance. The condition develops when the adrenal glands become damaged, affecting the body’s ability to respond to physical stress and maintain normal functions.
Early symptoms of Addison’s disease often develop gradually and include persistent fatigue, muscle weakness, unexplained weight loss, low blood pressure, and salt cravings. Many people also experience darkening of the skin (hyperpigmentation), particularly on scars, skin folds, and pressure points. Dizziness when standing, nausea, and irritability are also common early indicators.
Yes, most people with Addison’s disease can live normal, active lives with proper treatment. Daily hormone replacement therapy with hydrocortisone and fludrocortisone effectively manages the condition. Patients need to take medications consistently, carry emergency injection kits, wear medical alert identification, and adjust doses during illness or stress. With proper management, life expectancy is typically normal.
An Addisonian crisis can be triggered by physical stressors such as infections, injuries, surgery, severe dehydration, or sudden medication discontinuation. This life-threatening emergency occurs when the body’s cortisol demand exceeds what damaged adrenal glands can provide. Symptoms include severe weakness, confusion, severe abdominal pain, low blood pressure, and loss of consciousness requiring immediate medical attention.
Addison’s disease can have a hereditary component, particularly when caused by autoimmune conditions. While the disease itself isn’t directly inherited, the tendency toward autoimmune disorders can run in families. Some genetic syndromes like autoimmune polyglandular syndrome also increase risk. However, most cases occur without a clear family history.
Diagnosis involves blood tests measuring cortisol and ACTH (adrenocorticotropic hormone) levels, often through an ACTH stimulation test. Doctors check electrolyte levels, particularly sodium and potassium, and may order antibody tests to identify autoimmune causes. Imaging studies like CT scans help examine the adrenal glands for damage or abnormalities.
Addison’s disease is primary adrenal insufficiency, meaning the problem originates in the adrenal glands themselves. Secondary adrenal insufficiency occurs when the pituitary gland doesn’t produce enough ACTH to stimulate the adrenals. While both conditions involve insufficient cortisol production, Addison’s disease also typically affects aldosterone production, whereas secondary adrenal insufficiency usually doesn’t.
There are no specific foods to avoid, but maintaining a balanced diet with adequate sodium is important since aldosterone deficiency causes salt loss. Some patients need to increase salt intake, especially during hot weather or exercise. Avoid excessive potassium-rich foods if potassium levels are elevated. Always discuss dietary needs with your healthcare provider based on your specific electrolyte levels.
- How to recognize Addison’s disease symptoms?
Watch for chronic fatigue, muscle weakness, unexplained weight loss, skin darkening, salt cravings, and low blood pressure. If you experience multiple symptoms persisting for weeks, consult an endocrinologist for testing.
- How to manage Addison’s disease daily?
Take hormone replacement medications at consistent times, never skip doses, carry an emergency injection kit, wear medical alert jewelry, and adjust medication during stress or illness as directed by your doctor.
- How to prevent an Addisonian crisis?
Double or triple your cortisol dose during illness, injury, or major stress. Always carry emergency injectable hydrocortisone, stay hydrated, and seek immediate medical care if you experience severe weakness, vomiting, or confusion.
- How to test for Addison’s disease?
Your doctor will perform blood tests measuring cortisol and ACTH levels, typically using an ACTH stimulation test. Additional tests include electrolyte panels, antibody tests, and imaging of the adrenal glands.
