Adrenal insufficiency

Abstract

Adrenal insuffi ciency is a rare endocrine disorder, characterized by an inappropriate secretion of adrenal hormones. It can be caused either by adrenal failure (Addison’s disease, primary adrenal insuffi ciency) or by dysfunction of the integrity of the hypothalamic-pituitary-adrenal axis (secondary adrenal insuffi ciency). Primary adrenal insuffi ciency occurs with an estimated prevalence of 93-140 per million and is less frequently diagnosed than secondary adrenal insuffi ciency (prevalence of 150-280 per million) [ 1 ]. In the developed world, primary adrenal insuffi ciency most frequently stems from autoimmune adrenalitis, whereas in the developing world, infectious diseases such as tuberculosis or cytomegalovirus play a substantial etiological role. Pituitary adenomas and its treatment (surgical removal or radiation therapy) present the main causes of secondary adrenal insuffi ciency.