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Encyclopedia > Addison's disease
Addison's disease
Classification & external resources
ICD-10 E27.1-E27.2
ICD-9 255.4
DiseasesDB 222
MedlinePlus 000378
eMedicine med/42 
MeSH D000224

Addison's disease(also known as chronic adrenal insufficiency, hypocortisolism or hypocorticism) is a rare endocrine disorder in which the adrenal gland produces insufficient amounts of steroid hormones (glucocorticoids and often mineralocorticoids). It may develop in children as well as adults, and may occur as the result of a large number of underlying causes. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // E00-E35 - Endocrine diseases (E00-E07) Disorders of thyroid gland (E00) Congenital iodine-deficiency syndrome (E01) Iodine-deficiency-related thyroid disorders and allied conditions (E02) Subclinical iodine-deficiency hypothyroidism (E03) Other hypothyroidism (E030) Congenital hypothyroidism with diffuse goitre (E031) Congenital hypothyroidism without goitre (E032) Hypothyroidism due to medicaments and other... // E00-E35 - Endocrine diseases (E00-E07) Disorders of thyroid gland (E00) Congenital iodine-deficiency syndrome (E01) Iodine-deficiency-related thyroid disorders and allied conditions (E02) Subclinical iodine-deficiency hypothyroidism (E03) Other hypothyroidism (E030) Congenital hypothyroidism with diffuse goitre (E031) Congenital hypothyroidism without goitre (E032) Hypothyroidism due to medicaments and other... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... In medicine, adrenal insufficiency (or hypocortisolism) is the inability of the adrenal gland to produce adequate amounts of cortisol in response to stress. ... Cortisol is a corticosteroid hormone produced by the adrenal cortex (in the adrenal gland). ... The endocrine system is a control system of ductless endocrine glands that secrete chemical messengers called hormones that circulate within the body via the bloodstream to affect distant organs. ... In mammals, the adrenal glands (also known as suprarenal glands) are the triangle-shaped endocrine glands that sit on top of the kidneys; their name indicates that position (ad-, near or at + -renes, kidneys). They are chiefly responsible for regulating the stress response through the synthesis of corticosteroids and catecholamines... Steroid hormones are steroids which act as hormones. ... Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... Mineralocorticoids is a class of steroids characterised by their similarity to aldosterone and their influence on salt and water metabolism. ...


The condition is named after Dr Thomas Addison, the British physician who first described the condition in his 1855 On the Constitutional and Local Effects of Disease of the Suprarenal Capsules.[1] The adjective "Addisonian" is used for features of the condition, as well as patients with Addison's disease.[2] Thomas Addison was a renowned 19th-century English physician and scientist. ... The Doctor by Luke Fildes This article is about the term physician, one type of doctor; for other uses of the word doctor see Doctor. ... Year 1855 (MDCCCLV) was a common year starting on Monday (link will display the full calendar) of the Gregorian Calendar (or a common year starting on Saturday of the 12-day slower Julian calendar). ...


The condition is generally diagnosed with blood tests, medical imaging and additional investigations.[2] Treatment is with replacement of the hormones (oral hydrocortisone and fludrocortisone). If the disease is caused by an underlying problem, this is addressed. Regular follow-up and monitoring for other health problems is necessary.[2] Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... Medical imaging designates the ensemble of techniques and processes used to create images of the human body (or parts thereof) for clinical purposes (medical procedures seeking to reveal, diagnose or examine disease) or medical science (including the study of normal anatomy and function). ... Hydrocortisone is a synthetic corticosteroid drug which may be given by injection or by topical application. ... Fludrocortisone acetate is a synthetic corticosteroid with moderate glucocorticoid potency and much greater mineralocorticoid potency. ...

Contents

Signs and symptoms

Symptoms

The symptoms of Addison's disease develop insidiously, and it may take some time to be recognized. The most common symptoms are fatigue, muscle weakness, weight loss, vomiting, diarrhea, headache, sweating, changes in mood and personality and joint and muscle pains. Some have marked cravings for salty foods due to the urinary losses of sodium.[2] “Fatigue (physical)” redirects here. ... See also Muscle Atrophy Muscle weakness (or lack of strength) is a direct term for It is the inability to exert force with ones muscles to the degree that would be expected given the individuals general physical fitness. ... Vomiting (also throwing up or emesis) is the forceful expulsion of the contents of ones stomach through the mouth and sometimes the nose. ... Types 5-7 on the Bristol Stool Chart are often associated with diarrhea Diarrhea (in American English) or diarrhoea (in British English) is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause... A headache (cephalalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Perspiration (also called sweating or sometimes transpiration) is the production and evaporation of a fluid, consisting primarily of water as well as a smaller amount of sodium chloride (the main constituent of table salt), that is excreted by the sweat glands in the skin of mammals. ... This article does not cite any references or sources. ... Myalgia means muscle pain and is a symptom of many diseases and disorders. ...


Clinical signs

On examination, the following may be noticed:[2]

  • Low blood pressure that falls further when standing (orthostatic hypotension)
  • Darkening (hyperpigmentation) of the skin, including areas not exposed to the sun; characteristic sites are skin creases (e.g. of the hands), nipples, and the inside of the cheek (buccal mucosa), also old scars may darken.
  • Signs of conditions that often occur together with Addison's: goiter and vitiligo

In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... Orthostatic hypotension (also known as postural hypotension, orthostatic intolerance and, colloquially, as head rush or a dizzy spell) is a sudden fall in blood pressure, typically greater than 20/10 mm Hg, that occurs when a person assumes a standing position, usually after a prolonged period of rest. ... A goitre (or goiter) (Latin struma) is a swelling in the neck (just below adams apple or larynx) due to an enlarged thyroid gland. ... Vitiligo (IPA ) or leukoderma is a chronic skin condition that causes loss of pigment, resulting in irregular pale patches of skin. ...

Addisonian crisis

An "Addisonian crisis" is a constellation of symptoms that indicate severe adrenal insufficiency. This may be the result of either previously undiagnosed Addison's disease, a disease process suddenly affecting adrenal function (such as adrenal hemorrhage, or in a patient with known Addison's disease who has suffered an intercurrent problem (e.g. infection, trauma). Additionally, this situation may develop in those on long-term oral glucocorticoids who have suddenly ceased taking their medication. Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ...


Untreated, an Addisonian crisis can be fatal. It is a medical emergency, usually requiring hospitalization. Characteristic symptoms are:[citation needed] {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ...

Dehydration (hypohydration) is the removal of water (hydro in ancient Greek) from an object. ... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... It has been suggested that Central Ischaemic Response be merged into this article or section. ... Hypoglycemia (hypoglycaemia in British English) is a medical term referring to a pathologic state produced by a lower than normal level of glucose (sugar) in the blood. ... This article is about epileptic seizures. ...

Diagnosis

Suggestive features

Routine investigations may show:[2]

Hypoglycemia (hypoglycaemia in British English) is a medical term referring to a pathologic state produced by a lower than normal level of glucose (sugar) in the blood. ... The electrolyte disturbance hyponatremia exists when the sodium level in the plasma falls below 135 mmol/l. ... Hyperkalemia is an elevated blood level (above 5. ... General Name, symbol, number potassium, K, 19 Chemical series alkali metals Group, period, block 1, 4, s Appearance silvery white Standard atomic weight 39. ... Aldosterone is a steroid hormone (mineralocorticoid family) produced by the outer-section (zona glomerulosa) of the adrenal cortex in the adrenal gland to regulate sodium and potassium balance in the blood. ... Eosinophilia is the state of having high eosinophil granulocytes in the blood. ... Lymphocytosis is an increase in the number of lymphocytes in the blood. ... Eosinophils are white blood cells that are responsible for combating infection by parasites in the body. ... A scanning electron microscope (SEM) image of a single human lymphocyte. ... “White Blood Cells” redirects here. ...

Testing

In suspected cases of Addison's disease, one needs to demonstrate that adrenal hormone levels are low even after appropriate stimulation with synthetic pituitary hormone tetracosactide. Two tests are performed, the short and the long test. Image File history File links Download high-resolution version (1100x873, 46 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Cortisol ... Image File history File links Download high-resolution version (1100x873, 46 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Cortisol ... Cortisol is a corticosteroid hormone produced by the adrenal cortex (in the adrenal gland). ... Image File history File links Size of this preview: 800 × 570 pixels Full resolution (1100 × 784 pixel, file size: 46 KB, MIME type: image/png) Afterwards please add the following code to : (Please review the discussion here. ... Image File history File links Size of this preview: 800 × 570 pixels Full resolution (1100 × 784 pixel, file size: 46 KB, MIME type: image/png) Afterwards please add the following code to : (Please review the discussion here. ... Aldosterone is a steroid hormone (mineralocorticoid family) produced by the outer-section (zona glomerulosa) of the adrenal cortex in the adrenal gland to regulate sodium and potassium balance in the blood. ... Tetracosactide is a synthetic analogue of the naturally-occurring hormone, adrenocorticotrophic hormone (ACTH). ...


The short test compares blood cortisol levels before and after 250 micrograms of tetracosactide (IM/IV) is given. If, one hour later, plasma cortisol exceeds 170 nmol/L and has risen by at least 330 nmol/L to at least 690 nmol/L, adrenal failure is excluded. If the short test is abnormal, the long test is used to differentiate between primary adrenal failure and secondary adrenocortical failure. Look up plasma in Wiktionary, the free dictionary. ...


The long test uses 1 mg tetracosactide (IM). Blood is taken 1, 4, 8, and 24 hours later. Normal plasma cortisol level should reach 1000 nmol/L by 4 hours. In primary Addison's disease, the cortisol level is reduced at all stages whereas in secondary corticoadrenal insufficiency, a delayed but normal response is seen.


Other tests that may be performed to distinguish between various causes of hypoadrenalism are renin and adrenocorticotropic hormone levels, as well as medical imaging - usually in the form of ultrasound, computed tomography or magnetic resonance imaging (MRI). Not to be confused with rennin, the active enzyme in rennet. ... Adrenocorticotropic hormone (ACTH or corticotropin) is a polypeptide hormone produced and secreted by the pituitary gland. ... Medical imaging designates the ensemble of techniques and processes used to create images of the human body (or parts thereof) for clinical purposes (medical procedures seeking to reveal, diagnose or examine disease) or medical science (including the study of normal anatomy and function). ... Medical ultrasonography (sonography) is an ultrasound-based diagnostic imaging technique used to visualize muscles and internal organs, their size, structures and possible pathologies or lesions. ... It has been suggested that Synchrotron X-ray tomographic microscopy, X-ray tomography be merged into this article or section. ... “MRI” redirects here. ...


Causes

Causes of adrenal insufficiency can be grouped by the way in which they cause the adrenals to produce insufficient cortisol. These are adrenal dysgenesis (the gland has not formed adequately during development), impaired steroidogenesis (the gland is present but is biochemically unable to produce cortisol) or adrenal destruction (disease processes leading to the gland being damaged).[2]

Adrenal dysgenesis

All causes in this category are genetic, and generally very rare. These include mutations to the SF1 transcription factor, congenital adrenal hypoplasia (AHC) due to DAX-1 gene mutations and mutations to the ACTH receptor gene (or related genes, such as in the Triple A or Allgrove syndrome). DAX-1 mutations may cluster in a syndrome with glycerol kinase deficiency with a number of other symptoms when DAX-1 is deleted together with a number of other genes.[2] This article is about mutation in biology, for other meanings see: mutation (disambiguation). ... In molecular biology, a transcription factor is a protein that binds DNA at a specific promoter or enhancer region or site, where it regulates transcription. ... X-linked adrenal hypoplasia congenita is a genetic disorder that mainly affects males. ... The ACTH receptor is a type of melanocortin receptor (type 2) which is specific for ACTH. It is found in the zona fasciculata of the adrenal cortex and stimulates production of cortisol. ... Triple-A syndrome is rare autosomal recessive disorder. ... Glycerol kinase is a phosphotransferase enzyme involved in lipolysis. ...

Impaired steroidogenesis

To form cortisol, the adrenal gland requires cholesterol, which is then converted biochemically into steroid hormones. Interruptions in the delivery of cholesterol include Smith-Lemli-Opitz syndrome and abetalipoproteinemia. Of the synthesis problems, congenital adrenal hyperplasia is the most common (in various forms: 21-hydroxylase, 17α-hydroxylase, 11β-hydroxylase and 3β-hydroxysteroid dehydrogenase), lipod CAH due to deficiency of StAR and mitochondrial DNA mutations.[2] Cholesterol is a sterol (a combination steroid and alcohol), a lipid found in the cell membranes of all body tissues, and is transported in the blood plasma of all animals. ... Smith-Lemli-Opitz syndrome is a developmental disorder that affects many parts of the body. ... Abetalipoproteinemia is a rare genetic disorder (autosomal recessive) that interferes with the normal absorption of fat and fat soluble vitamins from food. ... Congenital adrenal hyperplasia (CAH) refers to any of several autosomal recessive diseases resulting from defects in steps of the synthesis of cortisol from cholesterol by the adrenal glands. ... Congenital adrenal hyperplasia due to 21-hydroxylase deficiency, in all its forms, accounts for about 95% of diagnosed cases of congenital adrenal hyperplasia, and CAH in most contexts refers to 21-hydroxylase deficiency. ... Congenital adrenal hyperplasia due to 17α-hydroxylase deficiency is an uncommon form of congenital adrenal hyperplasia resulting from a defect in the gene for the enzyme CYP17A1, which mediates several key transformations in the synthesis of both cortisol and sex steroids. ... 11β-Hydroxylase deficient congenital adrenal hyperplasia (11β-OH CAH) is an uncommon form of congenital adrenal hyperplasia resulting from a defect in the gene for the enzyme which mediates the final step of cortisol synthesis in the adrenal. ... 3β-Hydroxysteroid dehydrogenase II deficient congenital adrenal hyperplasia (3βHSD CAH) is an uncommon form of CAH resulting from a defective gene for one of the key enzymes in cortisol synthesis by the adrenal glands. ... Lipoid congenital adrenal hyperplasia refers to an uncommon form of CAH resulting from defects in the earliest stages of adrenal cortisol synthesis: the transport of cholesterol into the mitochondria of the cells of the adrenal cortex and the conversion to pregnenolone. ... The steroidogenic acute regulatory protein, commonly referred to as StAR, is a transport protein that regulates cholesterol transfer within the mitochondria, a rate limiting step in the production of steroid hormones. ... Mitochondrial DNA (some captions in German) Mitochondrial DNA (mtDNA) is the DNA located in organelles called mitochondria. ...

Adrenal destruction

Autoimmune destruction of the adrenal cortex (often due to antibodies against the enzyme 21-Hydroxylase) is a common cause of Addison's in teenagers and adults. This may be isolated or in the context of autoimmune polyendocrine syndrome (APS type 1 or 2). Adrenal destruction is also a feature of adrenoleukodystrophy (ALD), and when the adrenal glands are involved in metastasis (seeding of cancer cells from elsewhere in the body), hemorrhage (e.g. in Waterhouse-Friderichsen syndrome or antiphospholipid syndrome), particular infections (tuberculosis, histoplasmosis, coccidioidomycosis), deposition of abnormal protein in amyloidosis. Some medications interfere with steroid synthesis enzymes (e.g. ketoconazole), while others accelerate the normal breakdown of hormones by the liver (e.g. rifampicin, phenytoin).[2] Autoimmunity is the failure of an organism to recognize its own constituent parts (down to the sub-molecular levels) as self, which results in an immune response against its own cells and tissues. ... 21-Hydroxylase (or Steroid 21-β-Monooxygenase) is an enzyme which is involved with the biosynthesis of the steroid hormones aldosterone and cortisol. ... In medicine, autoimmune polyendocrine syndromes are a heterogenous group of rare diseases characterised by autoimmune activity against more than one endocrine organs, although non-endocrine organs can be affected. ... Adrenoleukodystrophy (ALD) is a degenerative disorder of myelin, a complex fatty neural tissue that insulates many nerves of the central and peripheral nervous systems. ... Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... To meet Wikipedias quality standards, this article or section may require cleanup. ... Waterhouse-Friderichsen syndrome is massive, usually bilateral, hemorrhage into the adrenal glands caused by fulminant meningococcemia. ... This article, image, template or category should belong in one or more categories. ... An infection is the detrimental colonization of a host organism by a foreign species. ... Tuberculosis (abbreviated as TB for tubercle bacillus or TuBerculosis) is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. ... Ketoconazole is a synthetic antifungal drug used to prevent and treat skin and fungal infections, especially in immunocompromised patients such as those with AIDS. Due to its side-effect profile, it has been superseded by newer antifungals, such as fluconazole and itraconazole. ... The liver is an organ present in vertebrates and some other animals. ... Rifampicin (INN) (IPA: ) or rifampin (USAN) is a bacteriocidal antibiotic drug of the rifamycin group. ... Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ...


Treatment

Maintenance treatment

Treatment for Addison's disease involves replacing the missing cortisol (usually in the form of hydrocortisone tablets) in a dosing regimen that mimics the physiological concentrations of cortisol. Treatment must usually be continued for life. In addition, many patients require fludrocortisone as replacement for the missing aldosterone. Caution must be exercised when the person with Addison's disease becomes unwell, has surgery or becomes pregnant. Medication may need to be increased during times of stress, infection, or injury. Hydrocortisone is a synthetic corticosteroid drug which may be given by injection or by topical application. ... Fludrocortisone acetate is a synthetic corticosteroid with moderate glucocorticoid potency and much greater mineralocorticoid potency. ... “Surgeon” redirects here. ... A pregnant woman Pregnancy is the process by which a mammalian female carries a live offspring from conception until it develops to the point where the offspring is capable of living outside the womb. ...


Addisonian crisis

Treatment for an acute attack, an Addisonian crisis, usually involves intravenous (into blood veins) injections of:

  • Cortisone (cortisol)
  • Saline solution (basically a salt water, same clear IV bag as used to treat dehydration)
  • Glucose

Cortisol is a corticosteroid hormone produced by the adrenal cortex (in the adrenal gland). ... Intravenous therapy or IV therapy is the giving of liquid substances directly into a vein. ... Glucose (Glc), a monosaccharide (or simple sugar), is an important carbohydrate in biology. ...

Surgery

Surgeries may require significant adjustments to medication regimens prior to, during, and following any surgical procedure. The best preparation for any surgery, regardless of how minor or routine it may normally be, is to speak to one's primary physician about the procedure and medication implications well in advance of the surgery.


Pregnancy

Many women with Addison's have given birth successfully and without complication, both through natural labor and through cesarean delivery. Both of these methods will require different preventative measures relating to Addison's medications and dosages. As is always the case, thorough communication with one's primary physician is the best course of action. Occasionally, oral intake of medications will cause debilitating nausea and vomiting, and thus the woman may be switched to injected medications until delivery. [3] Addison's treatment courses by the mother are generally considered safe for baby during pregnancy.


Epidemiology

The frequency rate of Addison's disease in the human population is sometimes estimated at roughly 1 in 100,000.[4] Some research and information sites put the number closer to 40-60 cases per 1 million population. (1/25,000-1/16,600)[5] (Determining accurate numbers for Addison's is problematic at best and some incidence figures are thought to be underestimates.[6]) Addison's can afflict persons of any age, gender, or ethnicity, but typically presents in adults between 30 and 50 years of age. Women are slightly more likely to develop Addison's according to some studies.[attribution needed] Research has shown no significant predispositions based on ethnicity.[5]


Prognosis

While treatment solutions for Addison's disease are far from precise, overall long-term prognosis is typically good. Because of individual physiological differences, each person with Addison's must work closely with their physician to adjust their medication dosage and schedule to find the most effective routine. Once this is accomplished (and occasional adjustments must be made from time to time, especially during periods of travel, stress, or other medical conditions), symptomology is usually greatly reduced or occasionally eliminated so long as the person continues their dosage schedule.


Canine hypoadrenocorticism

The condition is relatively rare, but has been diagnosed in all breeds of dogs. In general, it is underdiagnosed, and one has to have a clinical suspicion of it as an underlying disorder for many presenting complaints. Females are overrepresented, and the disease often appears in middle age (4-7 years), although any age or gender may be affected.


Hypoadrenocorticism is treated with prednisolone and/or fludrocortisone (Florinef (r)) or a monthly injection called Percorten V (desoxycorticosterone pivlate (DOCP)). Routine blood work is necessary periodically to assess therapy.


Most of the medications used in the therapy of hypoadrenocorticism cause excessive thirst and urination. It is absolutely vital to provide fresh drinking water for the canine sufferer.


If the owner knows about an upcoming stressful situation (shows, traveling etc.), patients generally need an increased dose of prednisone to help deal with the added stress. Avoidance of stress is important for dogs with hypoadrenocorticism.


Famous Addisonians

  • President John F. Kennedy is one of the best-known Addison's disease sufferers.
  • Popular singer Helen Reddy.[7]
  • Scientist Eugene Merle Shoemaker Co-discoverer of the Comet Shoemaker-Levy 9.[8]
  • French Carmelite nun and religious writer Blessed Elizabeth of the Trinity [9]
  • Jane Austen is thought to have been another, although the disease had not been described during her lifetime. [citation needed]
  • According to Dr. Carl Abbott, a Canadian medical researcher, Charles Dickens may also have been afflicted.[10]
  • Osama bin-Laden - may be an Addisonian: Lawrence Wright (The Looming Tower, 2006, p. 139) notes that bin-Laden manifests all the key symptoms: "low blood pressure, weight loss, muscle fatigue, stomach irritability, sharp back pains, dehydration, and an abnormal craving for salt". Bin-Laden is known to have been consuming large amounts of the drug Arcalion to treat his symptoms.

John Kennedy and JFK redirect here. ... 2003 Greatest Hits compilation Helen Reddy (born October 25, 1941 in Melbourne, Australia) is an Australian pop singer and actor. ... Eugene Shoemaker at a stereoscopic microscope used for asteroid discovery Eugene Shoemaker wearing a Bell rocket belt while training astronauts. ... Hubble Space Telescope image of Comet Shoemaker-Levy 9, taken on May 17, 1994. ... Blessed Elizabeth of the Trinity (July 18, 1880–November 9, 1906) was a French nun and religious writer. ... 1873 engraving of Jane Austen, based on a portrait drawn by her sister Cassandra. ... “Dickens” redirects here. ... Lawrence Wright is a Pulitzer Prize-winning American author, screenwriter and a staff writer for The New Yorker magazine, and a current fellow at the Center for Law and Security at the New York University School of Law. ... The Looming Tower: Al Qaeda and the Road to 9/11 is historical look at the way in which Al Qaeda came into being, the background for various terrorist attacks and how they were investigated, and the events that led to the 9/11-2001 terrorist attacks on the United... Sulbutiamine (brand name: Arcalion®) is a precursor to thiamine (i. ...

See also

References

  1. ^ Thomas Addison [1855]. On The Constitutional And Local Effects Of Disease Of The Supra-Renal Capsules (HTML reprint), London: Samuel Highley. 
  2. ^ a b c d e f g h i j Ten S, New M, Maclaren N (2001). "Clinical review 130: Addison's disease 2001". J. Clin. Endocrinol. Metab. 86 (7): 2909-22. PMID 11443143. 
  3. ^ addison's disease. Retrieved on 2007-07-25.
  4. ^ Addison Disease � Health information regarding this hormonal (endocrine) disorder on MedicineNet.com. Retrieved on 2007-07-25.
  5. ^ a b eMedicine - Addison Disease : Article by Sylvester Odeke. Retrieved on 2007-07-25.
  6. ^ medhelp. Retrieved on 2007-07-25.
  7. ^ The Australian Addison's Disease Association. Retrieved on 2007-07-25.
  8. ^ Eugene Shoemaker (1928-1997). Retrieved on 2007-07-25.
  9. ^ catholic-forum.com. Retrieved on 2007-07-25.
  10. ^ L. Williams et al. (1991). "The Nineteenth Century: Victorian Period". The Year's Work in English Studies 72 (1): 314–360. DOI:10.1093/ywes/72.1.314. 
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (June 2004). NIH Publication No. 04–3054: Addison's disease. Endocrine and Metabolic Diseases Information Service. National Institute for Health. Retrieved on 2006-06-07.

Thomas Addison was a renowned 19th-century English physician and scientist. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 206th day of the year (207th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 206th day of the year (207th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 206th day of the year (207th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 206th day of the year (207th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 206th day of the year (207th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 206th day of the year (207th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 206th day of the year (207th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... June 7 is the 158th day of the year in the Gregorian calendar (159th in leap years), with 207 days remaining. ...

External links

Main campus in downtown Rochester, Minnesota. ...

Support groups


  Results from FactBites:
 
addisons disease (1939 words)
The disease is a situation where the adrenal glands--two small organs that sit high in the cranial abdomen in front of the kidney are malfunctioning.
Addison's disease, more correctly termed hypoadrenocorticism, is a dysfunction and inadequate secretion activity of the adrenal cortex--and can be life threatening.
Fri, 31 Oct 1997 20:59:17 -0700 Addison's disease is a deficiency of the adrenal glands.
Addison's disease [Section Title] - Health encyclopaedia - NHS Direct (1276 words)
Addison's disease is a rare disorder of the adrenal glands that affects around 1 in 40,000 people in the UK.
The diagnosis of Addison's disease is made by looking at your symptoms, and by measuring the levels of cortisol and aldosterone in your blood.
People who have Addison's disease, and have not begun treatment, may be unable to cope with the stress of a surgical operation or severe injury.
  More results at FactBites »

 
 

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