Those with secondary or tertiary adrenal insufficiency will typically have preserved mineralocorticoid function due to the separate feedback systems. Secondary adrenal insufficiency results from a decreased level of adrenocorticotrophin hormone (ACTH) released from the pituitary gland, and tertiary adrenal insufficiency results from a decreased level of corticotrophin-releasing hormone (CRH) released from the hypothalamus.Īn important distinction in these patients is the presence of mineralocorticoid deficiency. Primary adrenal insufficiency occurs when there is a pathology affecting the adrenal gland itself. The decreasing or suppressed adrenal function may be masked until stress or illness triggers an adrenal crisis.Īdrenal insufficiency can be classified into primary, secondary, and tertiary causes. Due to its vague symptoms and varying degree of clinical presentation, a clinician must maintain a high level of suspicion for this disease. Primary adrenal insufficiency is also known as autoimmune adrenalitis or Addison disease.Īdrenal insufficiency ranges from mild nonspecific symptoms to life-threatening shock conditions. Destruction or dysfunction of the adrenal cortex mainly causes glucocorticoid and mineralocorticoid deficiency. The cortex is responsible for producing glucocorticoids, mineralocorticoids, and androgens. The adrenal cortex produces hormones necessary for normal body functioning deficiency of these hormones results in adrenal insufficiency. The adrenal gland is made up of two parts, the cortex and the medulla.
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