Table 1 Etiologies of Adrenal Insufficiency
Primary Forms | Secondary Forms |
|---|---|
Congenital | Congenital |
Congenital adrenal hyperplasia | Septo-optic dysplasia |
Congenital adrenal hypoplasia | Maternal hypercortisolemia (hypothalamic suppression) |
Familial glucocorticoid deficiency (ACTH unresponsiveness) | Corticotropin releasing hormone deficiency (hypothalamic disfunction) |
Allgrove syndrome (alachrima, achalasia, ACTH unresponsiveness) | ACTH deficiency (pituitary dysfunction) |
Metabolic disease | Pituitary aplasia/hypoplasia |
Adrenoleukodystrophy | Prader-Willi syndrome |
Smith-Lemli-Opitz syndrome | |
Wolman disease | |
Zellweger disease | |
Mitochondrial disease | |
Acquired | Acquired |
Autoimmune adrenalitis (Addison disease) | Chronic steroid use |
Isolated autoimmune adrenalitis | Abrupt steroid withdrawal |
Autoimmune polyendocrine syndrome | Increased metabolic demand |
Hemorrhage | Megesterol acetate (Megace) withdrawal |
Birth trauma | Tumor |
Trauma | Head trauma |
Meningococcemia (Waterhouse-Friderichsen syndrome) | Burn injury |
Medication | Radiation |
Ketoconazole | Infiltrative disease |
Etomidate | |
Infection | |
Cytomegalovirus | |
Human immunodeficiency virus | |
Fungal | |
Tubercolosis |