Secondary adrenal insufficiency pathophysiology

Adrenal insufficiency Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Xyz from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Interventions
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Secondary adrenal insufficiency pathophysiology On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Secondary adrenal insufficiency pathophysiology All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Secondary adrenal insufficiency pathophysiology
CDC on Secondary adrenal insufficiency pathophysiology
Secondary adrenal insufficiency pathophysiology in the news
Blogs on Secondary adrenal insufficiency pathophysiology
Directions to Hospitals Treating Psoriasis
Risk calculators and risk factors for Secondary adrenal insufficiency pathophysiology

Please help WikiDoc by adding content here. It's easy! Click here to learn about editing.

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

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR

[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Pathogenesis

Production of cortisol- Source :NIH, https://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease

• 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.

Genetics

• Secondary adrenal insufficiency is also caused by genetic disorders.
  • Combined pituitary hormone deficiency (CPHD)
  • Proopiomelanocortin deficiency (POMC)

• 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.

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].