Secondary adrenal insufficiency causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Overview

Secondary adrenal insufficiency is caused mainly by four categories, hypopituitarism, drugs, genetic and other causes. Life-threatening causes include acute withdrawal of steroids, adrenal hemorrhage, Waterhouse-Friderichson syndrome, anticoagulation and gastroenteritis which causes adrenal crisis. The common causes include chronic steroid therapy and its withdrawal, opiates, causes of panhypopituitarism and the less common causes are genetic causes which include combined pituitary hormone deficiency (CPHD), proopiomelanocortin deficiency POMC and isolated ACTH deficiency.

Causes

Life-threatening Causes

Life-threatening causes of secondary adrenal insufficiency include causes of acute adrenal crisis/insufficiency:

Common Causes

Secondary adrenal insufficiency may be caused by:

Less Common Causes

Less common causes of secondary adrenal insufficiency include:

Causes by Organ System

Cardiovascular Arteritis, Hypotension, Hemorrhage, Infarction
Chemical / poisoning No underlying causes
Dermatologic POEMS syndrome
Drug Side Effect Aminoglutethimide, Ciclesonide, Cidofovir, Corticosteroid withdrawal, Dexamethasone, Flunisolide, Pembrolizumab,prednisolone, Trilostane
Ear Nose Throat No underlying causes
Endocrine Allgrove syndrome, Achalasia-addisonian syndrome, Adrenal aplasia / adrenal hypoplasia, Adrenal metastases, After surgery of cortisol-secreting tumor, Autoimmune polyendocrine syndrome type 2, Bilateral adrenalectomy , Congenital adrenal hyperplasia, Glucocorticoid deficiency 1, IMAGE syndrome, POEMS syndrome, X-linked adrenal hypoplasia congenita
Environmental No underlying causes
Gastroenterologic Allgrove syndrome, Achalasia-addisonian syndrome, Hemochromatosis
Genetic Congenital adrenal hyperplasia, Cytochrome P450 oxidoreductase deficiency, Glycerol kinase deficiency, Hereditary ACTH resistance, IMAGE syndrome, X-linked adrenal hypoplasia congenita, Combined pituitary hormone deficiency (CPHD), Proopiomelanocortin deficiency (POMC), Isolated ACTH deficiency
Hematologic Anticoagulation, Coagulopathy , Embolus, Leukemia, Lymphoma , Thrombosis
Iatrogenic Iatrogenic, Radiation therapy, Chronic steroid therapy
Infectious Disease AIDS, Blastomycosis, CMV, Coccidiomycosis, Cryptococcosis, Histoplasmosis , Mycobacterium avium intracellulaire (MAI), Sepsis, Syphilis, Toxoplasmosis, Tuberculosis, Waterhouse-Friderichson syndrome
Musculoskeletal / Ortho IMAGE syndrome
Neurologic Adrenoleukodystrophy, Coma, Craniopharyngioma, Panhypopituitarism, POEMS syndrome
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Craniopharyngioma, Kaposi's sarcoma, Leukemia, Lymphoma , pituitary metastasis
Ophthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Sarcoidosis,
Renal / Electrolyte Uremia, Waterhouse-Friderichson syndrome
Rheum / Immune / Allergy Autoimmune, Autoimmune polyendocrine syndrome type 2, Sarcoidosis
Sexual No underlying causes
Trauma Trauma
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Amyloidosis, Idiopathic, Iatrogenic, Radiation therapy, Surgery, Surgical removal of pituitary, Surgical removal of hypothalamus

Causes in Alphabetical Order


References

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