Hypoadrenalism (chronic, secondary)
Adrenal atrophy from long term exogenous corticosteroid therapy is the most common cause of hypoadrenalism whether primary or secondary
- iatrogenic, tertiary adrenal insufficiency induced by chronic administration of high doses of glucocorticoids is the most common cause of adrenal insufficiency (1)
Other causes of secondary hypoadrenalism include:
- pituitary lesions:
- pituitary surgery
- irradiation
- adenoma
- pituitary apoplexy
- granulomatous disease e.g. sarcoidosis
- metastases
- Sheehan's syndrome (rare)
- idiopathic isolated ACTH deficiency (very rare)
- hypothalamic and mid-brain lesions:
- surgery & head injury
- tumour e.g. craniopharyngioma
- cranial irradiation
- granulomatous disease
Reference:
- Nicolaides NC, Pavlaki AN, Maria Alexandra MA, et al. Glucocorticoid Therapy and Adrenal Suppression. [Updated 2018 Oct 19]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.
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