Secondary adrenal insufficiency pathophysiology: Difference between revisions
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It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3]. | It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3]. | ||
OR | OR | ||
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==Associated Conditions== | ==Associated Conditions== | ||
*[[Hypopituitarism]] | |||
==Gross Pathology== | ==Gross Pathology== | ||
Revision as of 20:45, 9 October 2017
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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
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
OR
The progression to [disease name] usually involves the [molecular pathway].
OR
The pathophysiology of [disease/malignancy] depends on the histological subtype.
Pathophysiology
Pathogenesis
- Secondary adrenal insufficiency is caused by the processes occurring outside adrenal glands: pituitary causes, drugs, genetic causes.
- These disease processes causes the decreased production of adrenocorticotrophic hormone (ACTH).
- In drugs, chronic steroid therapy causes suppression of hypothalamic-pituitary-adrenal (HPA) axis.
- In some cases of adrenal insufficiency, hyponatremia is seen due to an abnormal increase in antidiuretic hormone(ADH) which in turn caused due to deficiency of cortisol due to decreased excretion of free water. The feedback loop causes secretion of corticotropin-releasing hormone (CRH), again an ADH secretagogue. There is a negative feedback on CRH and ACTH by cortisol. In adrenal insufficiency, this effect is removed and cortisol inhibits ADH excretion directly showing the reciprocal relation of ADH increase when cortisol is low. ADH inappropriate secretion leads to more water absorption leading to hyponatremia.[1]
Genetics
- Secondary adrenal insufficiency is also caused by genetic disorders.
- Combined pituitary hormone deficiency (CPHD)
- Proopiomelanocortin deficiency (POMC)[2]
- POMC deficiency is transmitted in autosomal recessive transmission pattern.
- Genes involved in the pathogenesis of POMC deficiency include POMC gene.
- The development of [disease name] is the result of multiple genetic mutations.
Associated Conditions
Gross Pathology
- On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
Microscopic Pathology
- On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
References
- ↑ Jessani N, Jehangir W, Behman D, Yousif A, Spiler IJ (2015). "Secondary adrenal insufficiency: an overlooked cause of hyponatremia". J Clin Med Res. 7 (4): 286–8. doi:10.14740/jocmr2041w. PMC 4330026. PMID 25699130.
- ↑ "Proopiomelanocortin Deficiency - GeneReviews® - NCBI Bookshelf".