The causes of primary hypoadrenalism are listed in TabieJ,. Tuberculosis, once a major cause of primary hypoadrenalism, has been largely replaced by autoimmune (Addison's) disease (either isolated or as part of a polyglandular autoimmune syndrome) as the leading cause of hypoadrenalism in the industrialized countries. Addison's disease has a marked female predilection and usually occurs in the third to fifth decades of life. Recently, AIDS has increasingly been recognized as a cause of primary adrenal dysfunction due to necrotizing adrenalitis.

Table 1 Causes of primary hypoadrenalism

Disseminated fungal infections, particularly histoplasmosis, can cause adrenal insufficiency in endemic areas. Metastatic infiltration of the adrenal glands is common, particularly in lung and breast cancer, but clinically recognized adrenal insufficiency is uncommon. Some drugs (e.g. ketoconazole, etomidate, suramin) inhibit cortisol biosynthesis, whereas others (e.g. rifampin (rifampicin), phenytoin) accelerate the metabolism of cortisol and these can induce adrenal insufficiency in patients with a limited hypothalamic-pituitary-adrenal axis reserve.

Was this article helpful?

0 0
Healthy Fat Loss For A Longer Life

Healthy Fat Loss For A Longer Life

What will this book do for me? A growing number of books for laymen on the subject of health have appeared in the past decade. Never before has there been such widespread popular interest in medical science. Learn more within this guide today and download your copy now.

Get My Free Ebook

Post a comment