ADRENAL INSUFFICIENCY

ADRENAL INSUFFICIENCY

Adrenal insu ffi ciency may be primary , secondary or tertiary . Primary insu ffi ciency (Addison’s disease) is due to adreno - cortical disease, whereas secondary and tertiary insu ffi ciency arise from pituitary and hypothalamic pathology , respectively . Addison’s disease most commonly occurs when there is auto - immune (70–90%) or tuberculous destruction of the adrenal cortex and results in glucocorticoid and mineralocorticoid en insu ffi ciency . This is in contrast to secondary disease (lack of ACTH) and tertiary disease (lack of CRH secretion), wher e th, UK, described this syndrome in 1911. e his account of the syndrome in 1918.

Type of AI Primary AI a Secondary AI Tertiary AI

tion (under control of the renin–angiotensin system) is spared. The causes are summarised in Table 57.1 .