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Pathology of Addison’s Disease

Matthew Rodriguez, Amanda Page

BIOL 20-23523

Fresno City College

Susan Mac Leod

11, 24, 2021

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The endocrine system is composed of organs and glands that regulate and coordinate the

body's metabolism, energy level, reproduction, development and growth, and response to injury,

mood, and stress by way of hormones (Foley et al., 2021). The organs involved in the endocrine

system are the pineal gland, the hypothalamus, the pituitary, the thyroid, the parathyroid, thymus,

adrenal glands, and the pancreas. (Marieb, Brady, & Mallat, 2019, p. 524). The pituitary gland

secretes eight hormones which are; TSH stimulates the thyroid gland to release thyroid

hormones, ACTH prompts the adrenal glands to release glucocorticoids and androgens, FSH

prompts estrogen production in the ovaries and sperm production in the testes, LH stimulates

estrogen and progesterone in the ovaries and testosterone in the testes, GH stimulates protein

synthesis and somatic growth, PRL prompts lactation, ADH stimulates kidney tubule cells to

absorb water, Oxytocin stimulates contractions and milk ejection (Marieb, Brady, & Mallat,

2019, p. 526). The pineal gland secretes melatonin, which regulates the sleep cycle (Marieb,

Brady, & Mallat, 2019, p. 437). Next, the hypothalamus secretes releasing and inhibiting

hormones that turn the anterior lobe of the pituitary gland on and off (Marieb, Brady, & Mallat,

2019, p. 527). The thyroid gland secretes TH (thyroid hormone) and its main function is to

increase basal metabolic rate. Also releasing calcitonin, which lowers blood levels of calcium

(Marieb, Brady, & Mallat, 2019, p. 532). The parathyroid gland releases PTH to raise blood

levels of calcium (Marieb, Brady, & Mallat, 2019, p. 533). The thymus secretes thymic

hormones to transform T lymphocytes from precursor cells (Marieb, Brady, & Mallat, 2019, p.

537). The Zona glomerulosa secretes aldosterone to prompt the kidney ducts to absorb more

sodium into the blood, cortisol is secreted by the zona fasciculata and zona reticularis to help the

body deal with stressful situations (Marieb, Brady, & Mallat, 2019, p. 537). The pancreas has

two types of cells, alpha and beta cells. Alpha cells secrete glucagon which signals the liver to
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release glucose, raising the blood sugar. Then beta cells secrete insulin which signals the rest of

the body to take glucose from the blood, lowering blood sugar (Marieb, Brady, & Mallat, 2019,

p. 537). Once hormones are secreted they then go to their target cells and bind to their specific

receptors and will react in a preprogrammed way (Marieb, Brady, & Mallat, 2019, p. 524). One

disorder of the endocrine system is called Addison's disease, which is also known as Primary

Adrenal Insufficiency (PAI). It is a fast-paced disorder that can be life-threatening if not

promptly treated. (Masahiro et al., 2017, p. 1). Furthermore, even though PAI is often acquired in

adults, in children, it is mostly caused by monogenic diseases (Çamtosun et al., 2021, p. 95). PAI

shows up differently in adults than in children (Chang, et al., 2021, p. 2)

PAI is a condition that inhibits the production of glucocorticoids (cortisol),

mineralocorticoids (aldosterone), and androgens by way of destruction of the adrenal cortex

(Shepherd et al., 2017, p. 2). As a result of cortical adrenal destruction low cortisol and

aldosterone concentrations persist. The adrenal glands are made up of three zones, zona

glomerulosa, zona fasciculata and zona reticularis. A PAI patient’s Zona glomerulosa will not

produce aldosterone while the patient’s Zona fasciculata will not produce cortisol (Osmosis,

2017). Aldosterone is secreted in response to elevated potassium levels, low blood, sodium

levels, low blood volume, and low blood pressure. As a consequence potassium blood levels and

sodium retention levels are increased. Which as a direct result increases blood volume and blood

pressure (Betts et al., 2013). Cortisol is secreted by the zona fasciculata and zona reticularis to

help the body deal with stressful situations such as trauma, anxiety, crowding, fasting, and

infection. In order to do so, cortisol keeps blood glucose levels high enough for the brain to

function well body cells are switched to fat and amino acids energy sources (Marieb, Brady, &

Mallat, 2019, p. 537).

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Reference

Primary Resources

Chang, Z., Lu, W., Zhao, Z., Xi, L., Li, X., Ye, R., Ni, J., Pei, Z., Zhang, M., Cheng, R.,

Zheng, Z., Sun, C., Wu, J., & Luo, F. (2021). Genetic aetiology of primary adrenal

insufficiency in Chinese children. BMC Medical Genomics, 14, 1–14.

Çamtosun, E., Dündar, İ., Akıncı, A., Kayaş, L., & Çiftci, N. (2021). Pediatric Primary

Adrenal Insufficiency: A 21-year Single Center Experience. Journal of Clinical Research in

Pediatric Endocrinology, 13(1), 88–99.

https://doi.org/10.4274/jcrpe.galenos.2020.2020.0132

Masahiro Iwasaku, Maki Shinzawa, Shiro Tanaka, Kimihiko Kimachi, & Koji Kawakami.

(2017). Clinical characteristics of adrenal crisis in adult population with and without

predisposing chronic adrenal insufficiency: a retrospective cohort study. BMC Endocrine

Disorders, 17, 1–10. https://doi.org/10.1186/s12902-017-0208-0

Shepherd, L. M., Tahrani, A. A., Inman, C., Arlt, W., & Carrick-Sen, D. M. (2017).

Exploration of knowledge and understanding in patients with primary adrenal insufficiency: a

mixed methods study. BMC Endocrine Disorders, 17, 1–10.

https://doi.org/10.1186/s12902-017-0196-0

Secondary and Tertiary Resources

Baum, H. (2021). The Endocrine System. www.uc.edu. Retrieved November 4, 2021, from

https://www.uc.edu/content/dam/uc/ce/docs/OLLI/Page%20Content/The%20Endocrine%20S

ystem.pdf.
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Foley, M., Turley, R. K., & Hurd, R. (Eds.). (2021). Anatomy of the Endocrine System. In

University of Rochester Medical Center. Retrieved November 4, 2021, from

https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=P0

0401.

The Mayo Clinic Staff. (2020, November 24). Addison's Disease. Mayo Clinic. Retrieved

November 16, 2021, from

https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-2035

0293.

(Osmosis. (2017, April 10). Primary adrenal insufficiency (Addison's disease) - pathology,

symptoms, diagnosis, treatment [Video]. YouTube.

https://www.youtube.com/watch?v=V6XcBp8EV7Q

Çamtosun, E., Dündar, İ., Akıncı, A., Kayaş, L., & Çiftci, N. (2021). Pediatric Primary

Adrenal Insufficiency: A 21-year Single Center Experience. Journal of Clinical Research in

Pediatric Endocrinology, 13(1), 88–99.

https://doi.org/10.4274/jcrpe.galenos.2020.2020.0132

Betts, J. G., DeSaix, P., Johnson, E., Johnson, J. E., Korol, O., Poe, B., Wise, J. A., Womble ,

M., & Young, K. A. (2013). Chapter 1: Introduction to the human body. In Anatomy &

Physiology. etext. https://openstax.org/books/anatomy-and-physiology/pages/1-introduction

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