Secondary adrenal insufficiency causes
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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
Secondary adrenal insufficiency is caused mainly by four categories, hypopituitarism, drugs, genetic and other causes. Life-threatening causes include acute withdrawal of steroids, adrenal hemorrhage, Waterhouse-Friderichson syndrome, anticoagulation and gastroenteritis which causes adrenal crisis. The common causes include chronic steroid therapy and its withdrawal, opiates, causes of panhypopituitarism and the less common causes are genetic causes which include combined pituitary hormone deficiency (CPHD), proopiomelanocortin deficiency POMC and isolated ACTH deficiency.
Causes
Life-threatening Causes
Life-threatening causes of secondary adrenal insufficiency include causes of acute adrenal crisis/insufficiency:
- Acute withdrawal of steroids.
- Traumatic hypopituitarism.[1]
- Adrenal hemorrhage
- Waterhouse-Friderichson syndrome
- Anticoagulation.
- Gastroenteritis.[2]
Common Causes
Secondary adrenal insufficiency may be caused by:
- Drugs
- Chronic steroid therapy and its withdrawal
- Opiates
- Etomidate
- Antifungals- ketoconazole[3]
- Pituitary causes:
- Infections- tuberculosis
- Pituitary infarction
- Pituitary removal
- Pituitary irradiation
Less Common Causes
Less common causes of secondary adrenal insufficiency include:
- Pituitary causes
- Genetic causes:
- Combined pituitary hormone deficiency (CPHD)
- Proopiomelanocortin deficiency (POMC)
- Isolated ACTH deficiency
Causes by Organ System
Causes in Alphabetical Order
References
- ↑ Ham PB, Cunningham AJ, Mentzer CJ, Ahmad A, Young LS, Abuzeid AM (2015). "Traumatic panhypopituitarism resulting in acute adrenal crisis". J Trauma Acute Care Surg. 79 (3): 484–9. doi:10.1097/TA.0000000000000771. PMID 26307884.
- ↑ Puar TH, Stikkelbroeck NM, Smans LC, Zelissen PM, Hermus AR (2016). "Adrenal Crisis: Still a Deadly Event in the 21st Century". Am J Med. 129 (3): 339.e1–9. doi:10.1016/j.amjmed.2015.08.021. PMID 26363354.
- ↑ "www.ucdenver.edu" (PDF).
- ↑ 4.0 4.1 Huebner A, Yoon SJ, Ozkinay F, Hilscher C, Lee H, Clark AJ; et al. (2000). "Triple A syndrome--clinical aspects and molecular genetics". Endocr Res. 26 (4): 751–9. PMID 11196451.
- ↑ Mosser J, Douar AM, Sarde CO, Kioschis P, Feil R, Moser H; et al. (1993). "Putative X-linked adrenoleukodystrophy gene shares unexpected homology with ABC transporters". Nature. 361 (6414): 726–30. doi:10.1038/361726a0. PMID 8441467.
- ↑ Shashidhar PK, Shashikala GV (2012). "Low dose adrenocorticotropic hormone test and adrenal insufficiency in critically ill acquired immunodeficiency syndrome patients". Indian J Endocrinol Metab. 16 (3): 389–94. doi:10.4103/2230-8210.95680. PMC 3354846. PMID 22629505.
- ↑ Eledrisi MS, Verghese AC (2001). "Adrenal insufficiency in HIV infection: a review and recommendations". Am. J. Med. Sci. 321 (2): 137–44. PMID 11217816.
- ↑ Cocco C, Meloni A, Mariotti S; et al. (2012). "Novel neuronal and endocrine autoantibody targets in autoimmune polyendocrine syndrome type 1". Autoimmunity. 45 (6): 485–94. doi:10.3109/08916934.2012.680632. PMID 22506635.
- ↑ Osa SR, Peterson RE, Roberts RB (1981). "Recovery of adrenal reserve following treatment of disseminated South American blastomycosis". Am. J. Med. 71 (2): 298–301. PMID 6266250.
- ↑ Ardalan M, Shoja MM (2009). "Cytomegalovirus-induced adrenal insufficiency in a renal transplant recipient". Transplant. Proc. 41 (7): 2915–6. doi:10.1016/j.transproceed.2009.07.024. PMID 19765472.
- ↑ Mihalache A, Lamy O, Waeber G, Schneider A (2007). "[Adrenal insufficiency and hypercalcemia--an unusual presentation]". Praxis (Bern 1994) (in German). 96 (45): 1761–5. PMID 18050601.
- ↑ Kawamura M, Miyazaki S, Mashiko S; et al. (1998). "Disseminated cryptococcosis associated with adrenal masses and insufficiency". Am. J. Med. Sci. 316 (1): 60–4. PMID 9671046.
- ↑ Turan S, Hughes C, Atay Z; et al. (2012). "An atypical case of familial glucocorticoid deficiency without pigmentation caused by coexistent homozygous mutations in MC2R (T152K) and MC1R (R160W)". J. Clin. Endocrinol. Metab. 97 (5): E771–4. doi:10.1210/jc.2011-2414. PMC 3396854. PMID 22337906.
- ↑ Francke U, Harper JF, Darras BT; et al. (1987). "Congenital adrenal hypoplasia, myopathy, and glycerol kinase deficiency: molecular genetic evidence for deletions". Am. J. Hum. Genet. 40 (3): 212–27. PMC 1684111. PMID 2883886.
- ↑ Pedersen-Bjergaard U, Thorsteinsson B, Kirkegaard BC (1996). "[Pituitary function in hemochromatosis]". Ugeskr. Laeg. (in Danish). 158 (13): 1818–22. PMID 8650756.
- ↑ Pedreira CC, Savarirayan R, Zacharin MR (2004). "IMAGe syndrome: a complex disorder affecting growth, adrenal and gonadal function, and skeletal development". J. Pediatr. 144 (2): 274–7. doi:10.1016/j.jpeds.2003.09.052. PMID 14760276.
- ↑ Weits J, Sprenger HG, Ilic P, van Klingeren B, Elema JD, Steensma JT (1991). "[Mycobacterium avium disease in AIDS patients; diagnosis and therapy]". Ned Tijdschr Geneeskd (in Dutch; Flemish). 135 (52): 2485–9. PMID 1758516.
- ↑ Dispenzieri A, Kyle RA, Lacy MQ; et al. (2003). "POEMS syndrome: definitions and long-term outcome". Blood. 101 (7): 2496–506. doi:10.1182/blood-2002-07-2299. PMID 12456500.
- ↑ Gostiljac DM, Dordević PB, Maric-zivković J, Canović F (2005). "[Sarcoidosis localized in endocrine glands]". Med. Pregl. 58 Suppl 1: 25–9. PMID 16526262.