Hypoadrenalism
Hypoadrenalism includes all conditions in which the secretion of adrenal steroid hormones falls below that required by the body.
One classification is that of:
- acute
- chronic:
- primary adrenal insufficiency - Addison's disease
- primary adrenal insufficiency, which involves deficiency of all adrenocortical hormones, is caused by (1)
- autoimmune destruction
- congenital adrenal hyperplasia
- pharmacological inhibition (eg, high doses of azole antifungal therapy)
- infection (eg, tuberculosis, fungal infections)
- surgical removal of adrenal cortical tissue
- primary adrenal insufficiency, which involves deficiency of all adrenocortical hormones, is caused by (1)
- secondary adrenal insufficiency
- secondary adrenal insufficiency is caused by disorders affecting the pituitary gland, such as (1):
- tumours,
- haemorrhage
- inflammatory or infiltrative conditions (eg, hypophysitis, sarcoidosis, hemochromatosis)
- surgery
- radiation therapy
- or medications that suppress corticotropin production, such as opioids
- glucocorticoid-induced adrenal insufficiency is caused by administration of supra-physiological doses of glucocorticoids
- secondary adrenal insufficiency is caused by disorders affecting the pituitary gland, such as (1):
- primary adrenal insufficiency - Addison's disease
Reference:
- Vaidya A, Findling J, Bancos I. Adrenal Insufficiency in Adults: A Review. JAMA. 2025;334(8):714–725.
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