Adrenal insufficiency classification

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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] Muhammad Saad, M.B.B.S.[3]

Overview

Adrenal insufficiency may be classified according to location of pathology into three subtypes primary adrenal insufficiency, secondary adrenal insufficiency, and glucocorticoid-induced adrenal insufficiency.[1]

Classification

Adrenal Insufficiency may be classified according to location of pathology into three subtypes:

Primary adrenal insufficiency:

In Primary adrenal insufficiency, the primary pathology lies in the adrenal glands leading to decreased production of cortisol, aldosterone and androgens. Although, the androgen deficiency manifests only in females as the adrenal gland is the only source of androgens in females.

Secondary adrenal insufficiency:

In Secondary adrenal insufficiency the pathology lies in the pituitary gland leading to reduced production of ACTH which is characterized by decreased cortisol and androgens production with preserved aldosterone secretion.[2]

Glucocorticoid-induced adrenal insufficiency:

Sometimes also known as tertiary adrenal insufficiency, glucocorticoid-induced adrenal insufficiency results from suppression of hypothalamic-pituitary-adrenal axis and is characterized by decreased production of cortisol and androgens with preserved aldosterone secretion.[1] It is the most common type of adrenal insufficiency .[3]Glucocorticoid induced adrenal insufficiency is the preferred term for adrenal insufficiency resulting from glucocorticoid use.[3]

References

  1. 1.0 1.1 "Adrenal Insufficiency in Adults: A Review | Endocrinology | JAMA | JAMA Network".
  2. Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K; et al. (2000). "Endotext". PMID 25905309.
  3. 3.0 3.1 Beuschlein F, Else T, Bancos I, Hahner S, Hamidi O, van Hulsteijn L, Husebye ES, Karavitaki N, Prete A, Vaidya A, Yedinak C, Dekkers OM (May 2024). "European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and therapy of glucocorticoid-induced adrenal insufficiency". Eur J Endocrinol. 190 (5): G25–G51. doi:10.1093/ejendo/lvae029. PMID 38714321 Check |pmid= value (help).

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