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Old 07-10-2012
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Question Addison's Disease Electrolytes!

how can we differentiate addison disease from say spironolactone based on electrolyte levels.

both have hyperkalemia with metabolic acidosis !
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Old 07-10-2012
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This ones easy!
Addisons will have hyperpigmentation due to increased ACTH release which will release melanin as well. (not too sure about orthostatic hypotension)
Moreover secondary hyperaldosteronism is associated with hypogylcemia.
Kaplan 2008 Pg 39
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Old 07-10-2012
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Addisons will have hyponatremia and they will be hypotensive or in shock... Also know. As "salt cravers"

Hyperaldosteronism will have high Na and will be hypertensive or upper normal
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Old 07-11-2012
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Quote:
Originally Posted by XpaezX View Post
Addisons will have hyponatremia and they will be hypotensive or in shock... Also know. As "salt cravers"

Hyperaldosteronism will have high Na and will be hypertensive or upper normal
how can we differentiate from spironolactone....spironolactone therapy causes high aldosterone levels but relative aldo deficiency in way it cannot act...so ?
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Old 07-13-2012
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Quote:
Originally Posted by tyagee View Post
how can we differentiate from spironolactone....spironolactone therapy causes high aldosterone levels but relative aldo deficiency in way it cannot act...so ?
we should check the levels of drug in body in that case .....
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Old 07-13-2012
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I don't think you can make a definitive distinction based on lab values alone. You'd probably have to look at the clinical scenario.

If you're talking about a person who is taking spironolactone or is older or has a history of high blood pressure, then spironolactone is definitely the most likely cause.

If it's a young person who has never had hypertension or has dark skin pigmentation, then it's Addison's.

If it's something in between, it may be hard to distinguish, but the question stem will definitely give you some little piece of information to make a clear distinction.

You could also measure ACTH levels or cortisol levels, since those will be decreased in Addison's and will be normal with spironolactone use. And aldosterone levels will be low in Addison's and high with spironolactone.
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Electrolytes-, Endocrinology-, Internal-Medicine-

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