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Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones. The adrenal glands—also referred to as the adrenal cortex—normally secrete glucocorticoids (primarily cortisol), mineralocorticoids (primarily aldosterone), and androgens.
Adrenal crisis, also known as Addisonian crisis or acute adrenal insufficiency, is a life-threatening complication of adrenal insufficiency. Hypotension, and hypovolemic shock, are the main symptoms of an adrenal crisis. Other symptoms include weakness, anorexia, nausea, vomiting, fever, fatigue, abnormal electrolytes, confusion, and coma.
Rapid onset of symptoms indicates acute adrenal failure, which is a clinical emergency. [5] An adrenal crisis can be triggered by stress, such as from an injury, surgery, or infection. [1] Addison's disease arises when the adrenal gland does not produce sufficient amounts of the steroid hormones cortisol and (sometimes) aldosterone. [1]
Two slices of an adrenal gland with a cortical adenoma, from a person with Conn's syndrome. The condition is due to: [14] Bilateral idiopathic (micronodular) adrenal hyperplasia: 66% of cases [1] Adrenal adenoma (Conn's disease): 33% of cases [1] Primary (unilateral) adrenal hyperplasia: 2% of cases
Two dexamethasone suppression tests (DSTs) are generally used, the overnight test and the 48 hour test. [8] For both tests, a plasma cortisol level above 50 nmol/L is indicative of Cushing's disease. [8] However, 3–8% of patients with Cushing's disease will test negative due to a retention of dexamethasone suppression abilities. [8]
Adrenal insufficiency is the clinical sign of insufficient glucocorticoid production or action, with or without concurrent insufficiency in mineralocorticoids and adrenal androgens. [21] Adrenocorticotropic hormone deficiency or exogenous glucocorticoid or opioid medication suppression of adrenocorticotropic hormone can cause adrenal ...
The dexamethasone suppression test (DST) is used to assess adrenal gland function by measuring how cortisol levels change in response to oral doses or an injection of dexamethasone. [1] It is typically used to diagnose Cushing's syndrome .
An important aspect of management of nonclassic CAH is suppression of central precocious puberty if it has begun. The usual clues to central puberty in boys are that the testes are pubertal in size, or that androgens of adrenal origin remain elevated even when the 17OHP has been reduced toward normal. In girls central puberty is less often a ...
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