Secondary adrenal insufficiency classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Classification
There are three major types of adrenal insufficiency.
- Primary adrenal insufficiency is due to impairment of the adrenal glands.
- One subtype is called idiopathic or unknown cause of adrenal insufficiency.
- 80% are due to an autoimmune disease called Addison's disease or autoimmune adrenalitis.
- Other cases are due to congenital adrenal hyperplasia or an adenoma (tumor) of the adrenal gland.
- Secondary adrenal insufficiency is caused by impairment of the pituitary gland or hypothalamus.[1] The most common cause in the United States is exogenous steroid use. Other causes are a pituitary adenoma or microadenoma, hypothalamic tumor (surgical removal of a pituitary tumor can also suppress production of ACTH and lead to adrenal deficiency); Sheehan's syndrome, which is associated with impairment of only the pituitary gland.
- Tertiary adrenal insufficiency is due to hypothalamic disease and decrease in corticotropin releasing factor (CRF).[2]