Addison's disease

Primary adrenal insufficiency: the adrenal cortex fails, so neither cortisol nor aldosterone is made. Most cases are autoimmune. It is rare, easily missed because its symptoms are vague, and fatal if untreated.

ICD-10 E27.1On the adrenals3 stages

Installation

bunx shadcn@4.22.1 add @organui/addisons-disease

This adds addisons-disease.tsx, the disease's data and component, to your components directory. It is built on the disease viewer and reuses the models of the adrenals, which install with it.

View registry item JSON

Usage

import { AddisonsDisease } from "@/components/addisons-disease"

export function AddisonsDiseaseDemo() {
  return <AddisonsDisease />
}

Every structure is a finding: affected structures are amber and spared ones muted. Select one, in 3D or in the panel, to read what the disease does there.

Course

Set stage or defaultStage to one of these. Each stage changes which structures are affected and the investigations to expect; the timeline under the model shows them in order, with the events along the way.

Gradual failure "gradual-failure" · Months
Tiredness, weight loss, poor appetite, craving for salt and dizziness on standing, often put down to stress or depression. The skin darkens, most in creases, scars and inside the mouth, as the pituitary drives ACTH up.
- Synacthen test: Cortisol measured before and 30 minutes after an injection of synthetic ACTH (tetracosactide). It barely rises from a failed cortex. In someone who is unwell, blood is taken for cortisol and ACTH, then hydrocortisone is given at once; treatment never waits for the test.
- Finding the cause: Antibodies to 21-hydroxylase confirm autoimmune disease. Without them, a CT of the adrenals looks for tuberculosis, bleeding or cancer. Autoimmune thyroid disease often comes with it, and type 1 diabetes less often.
Affects 2 structures of the adrenal glands.
Treated "treated" · Lifelong
Hydrocortisone two or three times a day and fludrocortisone once a day replace what the glands no longer make. Most feel well, but the dose must rise during illness, and a crisis can still follow vomiting or a missed dose.
- Replacement: Hydrocortisone in split doses, the largest on waking, to mimic the body's daily rhythm, and fludrocortisone for the missing aldosterone, adjusted by blood pressure, sodium, potassium and renin.
- Sick day rules: Double the hydrocortisone for a fever or an illness needing bed rest, and inject it if vomiting. A steroid emergency card tells others to give it, and an injection kit is kept at home.
Affects 2 structures of the adrenal glands.
Or Adrenal crisis "adrenal-crisis" · Hours
Before diagnosis, or when doses are not raised for an infection or vomiting: vomiting, abdominal pain, confusion and shock. Without hydrocortisone at once it is fatal.
- Emergency hydrocortisone (at once): Hydrocortisone 100 mg into a vein or muscle, then 200 mg over the next day, with a litre of saline in the first hour and glucose if it is low; then the infection or other trigger is treated.
Affects 2 structures of the adrenal glands.

Without Panel

Hide the panel to place the model in your own layout, and choose the scale and stage with props.

Controlled

Drive the stage, scale and selection from your own state, such as a patient's timeline.

API Reference

Import AddisonsDiseaseProps from the same file as AddisonsDisease.

AddisonsDisease props
Prop	Type	Default	Description
`scale`	`"adrenals"`	—	Control the scale shown.
`defaultScale`	`"adrenals"`	"adrenals"	Choose the scale shown first.
`onScaleChange`	`(scale: string) => void`	—	Receive the scale a reader chooses.
`stage`	`"gradual-failure" \| "treated" \| "adrenal-crisis"`	—	Control the stage shown.
`defaultStage`	`"gradual-failure" \| "treated" \| "adrenal-crisis"`	"gradual-failure"	Choose the stage shown first.
`onStageChange`	`(stage: string) => void`	—	Receive the stage a reader chooses.
`selectedId`	`string \| null`	null	Control the selected structure ID.
`onSelectionChange`	`(id: string \| null) => void`	—	Receive selections from the model and the panel.
`panel`	`boolean`	true	Show the scales, findings and investigations beside the model.
`timeline`	`boolean`	true	Show the course under the model, with its events and a play button. A disease with one stage has none.
`className`	`string`	—	Set the layout of the model and the panel.

Other props, such as visibility, controls, defaultView and ref, go to the organ viewer.

Models and licences

The component code is MIT. Each model keeps its own licence, and the viewer shows its credit; see Licences before hiding it.

Adrenal glands: BodyParts3D / Anatomography, © The Database Center for Life Science. CC BY-SA 2.1 Japan. Adapted by OrganUI., CC BY-SA 2.1 JP.

Educational, not for diagnosis or clinical decisions. The findings summarise typical disease; individual patients differ.