Adrenal Insufficiency
Consists of 2 types; primary and secondary
Primary adrenal insufficiency is also called Addison’s disease
ETIOLOGY
Primary
– Autoimmune (most common)
– Hemorrhage; trauma, illness, pregnancy
– Infections; HIV, CMV, TB
– Amyloidosis and Hemochromatosis
– Congenital
– Drugs; ketoconazole, etomidate, mitotane
Secondary
– Iatrogenic
CLINICAL FEATURES
– Weakness, Fatigue
– Weight loss
– Nausea, Vomiting, Diarrhea, Abdominal pain
– Orthostatic hypotension
– Coma, Death
– Hyper pigmentation of oral mucosa and palmar creases
DIAGNOSIS
– Blood work; BMP (hyponatremia, hyperkalemia)
– Cortisol test
– Cosyntropin stimulation test
TREATMENT
– Fludrocortisone, Hydrocortisone, Prednisone
