In The Family – Is Addison’s Hereditary?

The question we get asked most would have to be "Is Addison’s Disease hereditary?" Addison’s disease in it’s self is not hereditary but the factors which contributed to how you got Addison’s disease in the first place can be hereditary. As Doctor Paul Margulies explains in his answer on this hereditary pattern for the American N.A.D.F., "Most people with Addison’s disease have adrenal insufficiency caused by antibodies produced by mistake that injure both adrenal glands. This autoimmune tendency can be inherited. The gene that predisposes to this type of disorder appears on the 6th chromosome in the ‘HLA’ region" .

Just what the "rogue antibodies decide to attack" can be a bit of a lottery. For example you have Addison’s disease but other members of your family could develop the other known associated disorders like thyroid problems, diabetes mellitus, premature menopause, or more uncommonly, pernicious anaemia, vitiligo (patchy loss of skin pigment), underactive parathyroid glands (important in the body’s calcium metabolism), coeliac disease, Sjogren’s Disease (reduced secretion of tear fluid and salivation), chronic candida infections, chronic active hepatitis or hair loss.

Doctor Paul Margulies states, "Children of people with Addison’s disease would be slightly more likely to develop one of the autoimmune endocrine disorders, but the exact probabilities are uncertain." In our Association we have a surprising number of members who also have relatives with Addison’s disease. The record is set by the family which out of 8 children they have three sons with addison’s disease, three son’s with type1 diabetes, one son with coeliac disease and tragically a daughter who died from chronic active hepatitis. Their family case history, which is in this newsletter certainly makes interesting reading, and left me feeling nothing but admiration for the parents who deal with these health problems on a daily basis.

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One of our member’s had been ill for years, but it was not until, after a major operation when she lost 2 stone in 2 weeks and after an enormous amount of tests, that she was finally diagnosed in July 1985 with Addison’s Disease. She was aged 45 years at the time and had had an overall dark complexion the previous 12 months. Her brother had been sick for 2 weeks in February 1993 and was being treated for ulcers. He rapidly lost 4 stone in weight before he collapsed and was admitted to hospital for 3 or 4 days. He was sent home but soon was rushed back to hospital where he diagnosed with Addison’s disease. He was 44 years old at the time and his lips and elbows etc. were dark in colour.

Another of our members was diagnosed 1972 at 21 years of age with Addison’s disease while her sister was diagnosed in October 1996 when she was 50 years of age. We have a mother and daughter who both have Addison’s disease and are aware of a mother and her 10 year old son who were both diagnosed with Addison’s disease with in 6 months of each other. Surprisingly we have a brother and sister who originally had Cushings disease and as a result of having their adrenal glands removed, they now both have Addison’s disease.

However the story that took me by surprise was when we found out that the father of Lynne (who’s story appeared on the front of our July 1996 Newsletter) had recently been diagnosed with Addison’s disease at the age of 66 years. I am very conscious (probably over conscious) of the possibility of my own sister or her children developing Addison’s disease or any of the associated autoimmune disorders, but it had never entered my head that I should also be considering my mum and dad.

It was also disturbing to find that it was only through the family’s insistence that an ACTH test was done. Considering the fact that it was the same medical center Lynne had gone to for twenty years and all the doctors at the centre knew about her death from undiagnosed Addison’s disease, you would have thought, given the symptoms, that it would be automatic for the doctor to request an ACTH test. What does it take to convince doctor’s that Addison’s disease is a possibility especially if there is a family history of autoimmune disorders?

Don’t panic, just take Dr Paul Margulies advice,

"inform all family member’s to be aware of the existence of the signs and symptoms of Addison’s disease and also to look for the possibility of thyroid disease as well at the time of routine physical examinations and certainly at the time of any illnesses or change in health."

 
Reference:
Margulies Dr Paul, 1994, "What is the heredity pattern of Addison’s disease?", NADF News, Vol.VII, No.3 Spring/Summer ,pp.3, National Adrenal Diseases Foundation, New York.