It seems to be related to abnormalities in long chain fatty acids. The symptoms of Addison's disease can be related to various steroid deficiencies and may have a gradual or acute presentation. A characteristic early sign is a sense of weakness with undue fatigue. Occasionally patients experience salt craving. Lack or cortisol results in hypoglycemia, hyponatremia, hypopigmentation, abdominal pain and weakness.
Physical examination is usually most striking for abnormal pigmentation.
Lab tests revel diminished serum sodium, elevated serum potassium, and hypoglycemia. This may be performed by giving 25u of cortrosyn per square meter of body surface and obtaining a serum level 60 minutes later. It is important to note that mineralocorticoid treatment will effective only if salt is administered simultaneously. In growing children, it is important that the dose of steroid be titrated carefully. Growth retardation is a very sensitive index of glucocorticoid excess and can occur in the virtual absence of obesity, glucose intolerance, ecchymoses, or other signs of Cushing's syndrome.