Adrenal insufficiency - 2014 Lancet review

Adrenal insufficiency is the deficient production or action of glucocorticoids, with or without deficiency also in mineralocorticoids and adrenal androgens.

It is a life-threatening disorder that can result from:

- primary adrenal failure
- secondary adrenal disease due to impairment of the hypothalamic—pituitary axis

Prompt diagnosis and management are essential.

The clinical manifestations of primary adrenal insufficiency result from deficiency of all adrenocortical hormones, but they can also include signs of other concurrent autoimmune conditions.

In secondary or tertiary adrenal insufficiency, the clinical picture results from glucocorticoid deficiency only, but manifestations of the primary pathological disorder can also be present.

Diagnostic investigation can be challenging, especially in patients with secondary or tertiary adrenal insufficiency.


Adrenal insufficiency : The Lancet

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