Sandbox:Amd

Jump to navigation Jump to search


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

Hypoglycemia Anorexia Abdominal pain Muscle weakness Other history/

findings

Hyponatremia Cortisol levels Gold Standard
Differentiating Primary from Secondary adrenal insufficiency
Primary adrenal

insufficiency

  • Autoimmune/idiopathic
  • Infections- Tuberculosis[1], histoplasmosis
Cosyntropin/

ACTH stimulation test

Secondary adrenal

insufficiency

-
  • Hypopituitarism- Tumors, infections. hemorrhage/trauma
  • Drugs- Chronic steroid therapy and its withdrawal, Opiates[2][3]
  • Genetic- Combined pituitary hormone deficiency (CPHD), POMC (Proopiomelanocortin) gene deficiency[4]
Differentiating Adrenal Insufficiency from other diseases
  1. Patnaik MM, Deshpande AK (2008). "Diagnosis--Addison's disease secondary to tuberculosis of the adrenal glands". Clin Med Res. 6 (1): 29. doi:10.3121/cmr.2007.754a. PMC 2442022. PMID 18591375.
  2. George JM, Reier CE, Lanese RR, Rower M (1974). "Morphine anesthesia blocks cortisol and growth hormone response to surgical stress in humans". J. Clin. Endocrinol. Metab. 38 (5): 736–41. doi:10.1210/jcem-38-5-736. PMID 4823919.
  3. Müssig K, Knaus-Dittmann D, Schmidt H, Mörike K, Häring HU (2007). "Secondary adrenal failure and secondary amenorrhoea following hydromorphone treatment". Clin. Endocrinol. (Oxf). 66 (4): 604–5. doi:10.1111/j.1365-2265.2007.02779.x. PMID 17371484.
  4. Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean L, Bird TD, Ledbetter N, Mefford HC, Smith R, Stephens K, Challis BG, Millington G. PMID 24354022. Vancouver style error: initials (help); Missing or empty |title= (help)