Adrenal insufficiency causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayeesha Kattubadi, M.B.B.S[2]

Overview

Common causes of adrenal insufficiency include autoimmune adrenalitis and chronic glucocorticoid use.

Causes

Life threatening cause

• Adrenal crisis is a life-threatening cause of adrenal insufficiency.

Common Causes

Common causes of adrenal insufficiency include:

• Primary adrenal insufficiency: Autoimmune adrenalitis
• Central adrenal insufficiency: Chronic glucocorticoid use.

Less Common Causes

Less common causes of adrenal insufficiency include:

• Infections:
  • Tuberculosis
  • Fungal infections(histoplasma)
  • Cytomegalovirus
  • HIV
• Adrenal hemorrhage
• X-linked adrenoleukodystrophy
• Trauma
• Metastasis

The following table summarizes the causes of adrenal insufficiency.

Causes of adrenal insufficiency
Primary adrenal insufficiency (Addison's disease)	Secondary adrenal insufficiency	Tertiary adrenal insufficiency
Autoimmune: Sporadic Autoimmune polyglandular syndrome type 1 (APS type 1) Autoimmune polyglandular syndrome type 2 (Schmidt's syndrome) Infections: Tuberculosis, Fungal infections, Cytomegalovirus, HIV Adrenal Metastasis Adrenal infiltration Adrenal hemorrhage: Waterhouse-Friderichsen syndrome, Drugs - Anticoagulants- Heparin, Warfarin) Adrenoleukodystrophy Congenital adrenal hypoplasia Bilateral adrenelectomy	Pituitary tumors Iatrogeneic: Pituitary surgery, Pituitary radiation Granulomatous diseases: Tuberculosis Sarcoidosis Histiocytosis Wegener's granulomatosis Metastasis Pituitary apoplexy Sheehan's syndrome (Peripartum pituitary necrosis) Genetic: Isolated ACTH deficiency, Multiple pituitary hormone deficiencies Trauma	Glucocorticoid therapy Cushing's syndrome (Excess endogenous glucocorticoid production) Drugs: Mifepristone Chlorpromazine Imipramine Hypothalamic tumors (Primary and metastatic) Iatrogenic: Hypothalamic surgery Hypothalamic radiation Granulomatous diseases: Tuberculosis Sarcoidosis Histiocytosis Wegener's granulomatosis Trauma