User:Mr. Ibrahem/Adrenal insufficiency
| Adrenal insufficiency | |
|---|---|
 | |
| Forty-nine year-old with signs of adrenal insufficiency. Appearance shows lack of facial hair, dehydration, loss of the outer eyebrow (panel A), pale skin, muscular and weight loss, and loss of body hair (panel B).[1] | |
| Specialty | Endocrinology |
| Symptoms | Weakness, lightheadedness with standing, darkening skin, weight loss, vomiting, intolerance to the cold, salt cravings[2] |
| Complications | Adrenal crisis[3] |
| Types | Primary, secondary, tertiary |
| Causes | Primary: Addison disease, congenital adrenal hyperplasia, adrenal hemorrhage, certain medications[3] Secondary: Panhypopituitarism, Sheehan’s syndrome[4][5] Tertiary: Brain tumors, long term corticosteroid use[3][5] |
| Diagnostic method | Based on symptoms, confirmed by blood tests[4] |
| Treatment | Hydrocortisone, prednisone, fludrocortisone[2] |
| Prognosis | Often good with treatment[3] |
| Frequency | Primary: 5 in 100,000[6] Secondary: 22 per 100,000[5] |
Adrenal insufficiency is a condition in which the adrenal glands do not produce enough of the hormone cortisol and potentially aldosterone.[3] Symptoms vary from mild to severe.[3] Mild symptoms may include weakness, tiredness, lightheadedness with standing, and darkening skin.[2] More severe symptoms may include low blood pressure and weight loss.[2] There may also be vomiting, abdominal pain, intolerance to the cold, and salt cravings.[2][7] Complications may include an adrenal crisis.[3]
The causes of adrenal insufficiency are divided into primary, secondary, and tertiary.[3] Primary causes are due to the adrenal gland and include Addison disease, congenital adrenal hyperplasia, adrenal hemorrhage, and certain medications.[3] Secondary causes involve decreased ACTH from the pituitary and include panhypopituitarism and Sheehan’s syndrome.[3][4][5] Tertiary causes involve decreased CRH from the hypothalamus and include brain tumors and long term corticosteroid use.[3][5] Diagnosis is suspected based on symptoms and confirmed by blood tests.[4]
Treatment is generally with hydrocortisone or prednisone.[2][4] In primary disease fludrocortisone is also required.[2] Larger doses of hydrocortisone are required during physical stress, such as infections, and people are generally given injectable forms to self administer as soon as they feel sick.[2] Outcomes are often good with treatment.[3]
Primary adrenal insufficiency affects about 5 per 100,000 people.[6] Secondary adrenal insufficiency affects about 22 per 100,000 people.[5] Women are affected about twice as often as men.[6][5] The condition was first described in 1855 by Thomas Addison.[5]
References[edit]
- ^ Streetz-van der Werf, C; Karges, W; Blaum, M; Kreitschmann-Andermahr, I (15 May 2015). "Addisonian Crisis after Missed Diagnosis of Posttraumatic Hypopituitarism". Journal of clinical medicine. 4 (5): 965–9. doi:10.3390/jcm4050965. PMID 26239458.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ a b c d e f g h "Addison Disease - Endocrine and Metabolic Disorders". Merck Manuals Professional Edition. Retrieved 21 October 2020.
- ^ a b c d e f g h i j k l Huecker, MR; Dominique, E (January 2020). "Adrenal Insufficiency". PMID 28722862.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c d e "Secondary Adrenal Insufficiency - Endocrine and Metabolic Disorders". Merck Manuals Professional Edition. Retrieved 21 October 2020.
- ^ a b c d e f g h Nicolaides, NC; Chrousos, GP; Charmandari, E; Feingold, KR; Anawalt, B; Boyce, A; Chrousos, G; de Herder, WW; Dungan, K; Grossman, A; Hershman, JM; Hofland, HJ; Kaltsas, G; Koch, C; Kopp, P; Korbonits, M; McLachlan, R; Morley, JE; New, M; Purnell, J; Singer, F; Stratakis, CA; Trence, DL; Wilson, DP (2000). "Adrenal Insufficiency". PMID 25905309.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c Ferri, Fred F. (2014). Ferri's Clinical Advisor 2015 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 63. ISBN 978-0-323-08430-7. Retrieved 21 October 2020.
- ^ Ten S, New M, Maclaren N (2001). "Clinical review 130: Addison's disease 2001". J. Clin. Endocrinol. Metab. 86 (7): 2909–22. doi:10.1210/jcem.86.7.7636. PMID 11443143.