[Primary adrenal failure--causes, diagnostics and therapy].
METHODS
An overview of primary adrenal failure with emphasis on replacement therapy is presented. The article is based on a review of recent literature and authors' personal experience.


CONCLUSIONS
Addison's disease is usually caused by an autoimmune destruction of the adrenal cortex. It is relatively rare (prevalence 14 per 100,000 inhabitants), but often considered as a differential diagnosis when evaluating fatigue, tiredness and loss of weight. Addison's disease is treated by repletion of glucocorticoids and mineralocorticoids. The recommended starting dose is 25 mg cortisone acetate per day divided into three (12.5 + 6.25 + 6.25 mg) or two doses (12,5 mg x 2). Mineralocorticoid replacement is given as fludrocortisone 0.05 - 0.2 mg in one dose per day. Treatment with 20 - 50 mg dehydroepiandrosterone has been studied in adrenal failure, but the evidence for positive effects is weak, and it can not be recommended as standard treatment in primary adrenal failure.
Løvås
Kristian
K
Institutt for indremedisin, Universitetet i Bergen, Medisinsk avdeling Haukeland Universitetssykehus. kristian.lovas@helse-bergen.no
Erichsen
Martina Moter
MM
Husebye
Eystein S
ES
Fougner
Kristian J
KJ
Svartberg
Johan
J
Mella
Bjarne
B
Myhre
Anne Grethe
AG
Berg
Jens Petter
JP
Aarskog
Dagfinn
D
D000224:Addison Disease / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male
D005938:Glucocorticoids