Sandbox:Amd

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Adrenal Insufficiency

Disease	Clinical history/findings							Causes	Investigations/ Laboratory findings			Medical management	Surgical management
	Hypotension	Skin pigmentation/ findings	Fatigue	Anorexia/ Weightloss	Abdominal pain	Muscle weakness	Other history/ findings		Hypo natremia	Cortisol levels	Gold Standard
Differentiating amongst adrenal insufficiencies
Primary adrenal insufficiency	✔	✔	✔	✔	✔	✔		Autoimmune/idiopathic Infections- Tuberculosis, histoplasmosis	✔	↓	Cosyntropin/ ACTH stimulation test
Secondary adrenal insufficiency	✔	-	✔	✔				Hypopituitarism- Tumors, infections. hemorrhage/trauma Drugs- Chronic steroid therapy and its withdrawal, Opiates Genetic- Combined pituitary hormone deficiency (CPHD), POMC (Proopiomelanocortin) gene deficiency	-	Normal
Acute adrenal insufficiency	↓↓		✔	✔	✔	Signs of shock Altered mental status/ Loss of consciousness/ Coma Fever	Infection Tumor
Differentiating Adrenal Insufficiency from other diseases