Secondary adrenal insufficiency classification
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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
Adrenal insufficiency is classified into 2 types based on the level of impairment, primary adrenal insufficiency and secondary adrenal insufficiency. Secondary adrenal insufficiency may be further classified based on the causes into three types, such as hypopituitary causes, medication causes, and genetic causes.
Classification
Adrenal insufficiency is classified into 2 types based on the level of impairment.
Primary adrenal insufficiency
- Primary adrenal insufficiency is due to impairment of the adrenal gland, 80% due to an autoimmune disease called Addison's disease or autoimmune adrenalitis. Also, the other cause includes autoimmune polyendocrine syndrome type 1 and type 2.
Secondary adrenal insufficiency
- Secondary adrenal insufficiency is caused by impairment of the pituitary gland or hypothalamus. The 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.
- Secondary adrenal insufficiency may be further classified based on the causes into three types:
- Hypopituitary causes
- Medication induced
- Genetics
| Adrenal Insufficiency | |||||||||||||||||||||||||||||||||||||
| Primary adrenal insufficiency | Secondary adrenal insufficiency | ||||||||||||||||||||||||||||||||||||
| •Addison's disease •Autoimmune adrenalitis •Autoimmune polyendocrine syndrome type 1 and type 2 •Idiopathic | Hypopituitarism •Tumors-Craniopharyngioma •Tuberculosis[1][2] •Histoplasmosis [3] •Pituitary infarction-Sheehan's syndrome, pituitary apoplexy •Removal of pituitary due to metastasis •Lymphycytic hypophysitis •Head trauma •Intracranial artery aneurysms Drugs •Chronic high dose steroid •Opiates- Codeine, Morphine Genetic causes •Isolated ACTH deficiency •POMC deficiency •Combined Pituitary Hormone Deficiency (CPHD) | ||||||||||||||||||||||||||||||||||||
References
- ↑ Al-Mamari A, Balkhair A, Gujjar A, Ben Abid F, Al-Farqani A, Al-Hamadani A, Jain R (2009). "A case of disseminated tuberculosis with adrenal insufficiency". Sultan Qaboos Univ Med J. 9 (3): 324–7. PMC 3074785. PMID 21509318.
- ↑ Upadhyay, Jagriti; Sudhindra, Praveen; Abraham, George; Trivedi, Nitin (2014). "Tuberculosis of the Adrenal Gland: A Case Report and Review of the Literature of Infections of the Adrenal Gland". International Journal of Endocrinology. 2014: 1–7. doi:10.1155/2014/876037. ISSN 1687-8337.
- ↑ Bhansali A, Das S, Dutta P, Walia R, Nahar U, Singh SK; et al. (2012). "Adrenal histoplasmosis: unusual presentations". J Assoc Physicians India. 60: 54–8. PMID 23777028.