Secondary adrenal insufficiency

Adrenal insufficiency
Adrenal gland

Adrenal insufficiency Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: hypocortisolism; hypocorticism; adrenocortical hypofunction

Classification

Three major types:

1. Primary adrenal insufficiency

It is due to impairment of the adrenal glands. 80% are due to an autoimmune disease called Addison's disease or autoimmune adrenalitis. One subtype is called idiopathic, meaning of unknown cause. Other cases are due to congenital adrenal hyperplasia or an adenoma (tumor) of the adrenal gland.

1. Secondary adrenal insufficiency:

caused by impairment of the pituitary gland or hypothalamus.[1] Its principal causes include pituitary adenoma (which can suppress production of adrenocorticotropic hormone (ACTH) and lead to adrenal deficiency unless the endogenous hormones are replaced); and Sheehan's syndrome, which is associated with impairment of only the pituitary gland.

1. Tertiary adrenal insufficiency:

due to hypothalamic disease and a decrease in the release of corticotropin releasing hormone (CRH).[2] Causes can include brain tumors and sudden withdrawal from long-term exogenous steroid use (which is the most common cause overall).[3]

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case#1

Related Chapters

• Addison disease, primary adrenocortical insufficiency
• ACTH stimulation test
• Cushing's syndrome, overproduction of cortisol
• Insulin tolerance test, another test used to identify sub-types of adrenal insufficiency.
• Adrenal fatigue (hypoadrenia), a term used in alternative medicine to describe a believed exhaustion of the adrenal glands.

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