Adrenal Insufficiency And Adrenal Crisis

Gene Ragland

Pathophysiology.. .oLths. MrenalG—ds

Cortisol

Aldosterone

Androgens

PrimaryAdrenaj .InsufficiencY

Idiopathic

Infiltrative.. or.Infectious

Bilateral. .AdreMl.Mem.oirh.a.gp Miscellaneous

Clinjcal ..Features

Secondary...and.. Tertiary ..Ad.ren.aLln?uífic.ie,n.CY ClinMLFeatures Diagnosis Treatment Glucocorticoid

Mlneraioco—oid

Androgen

Secionnidaryn.Insiufficiency

AdrenalCrisis

Clinical . .Features

Treatment

Fluids

Steroids

Simultaneouslreatment „and.Jesting

Bii.b|i.ographY

Adrenal insufficiency consists of decreased levels or absence of hormones produced by the adrenal glands and results from structural or functional lesions of the adrenal cortex, the anterior pituitary gland, or the hypothalamus. Deficit of adrenal hormones may manifest clinically as a chronic, insidious disorder, or as an acute, life-threatening emergency. Therapy of adrenal insufficiency is specific and includes replacement of the deficient hormones.

Chronic adrenal insufficiency is due to a variety of causes. It may be primary (Addison's disease), due to failure of the adrenal glands. It also may occur secondarily because of failure of the pituitary gland (hypopituitarism) or as a tertiary insufficiency due to hypothalamic dysfunction. Iatrogenic adrenal suppression from chronic steroid use is termed iatrogenic tertiary adrenal insufficiency. Acute adrenal insufficiency (adrenal crisis) may result from certain acute events, or when a person with chronic adrenal insufficiency is subjected to stress and exhausts reserve adrenal hormones, or when replacement hormone medication is discontinued.

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