Adrenal Insufficiency - Types

Types

There are three major types of adrenal insufficiency.

  • Primary adrenal insufficiency is due to impairment of the adrenal glands.
    • One subtype is called idiopathic or unknown cause of adrenal insufficiency.
    • 80% are due to an autoimmune disease called Addison's disease or autoimmune adrenalitis.
    • Other cases are due to congenital adrenal hyperplasia or an adenoma (tumor) of the adrenal gland.
  • Secondary adrenal insufficiency is caused by impairment of the pituitary gland or hypothalamus. The most common cause in the United States is exogenous steroid use. Other causes are a pituitary adenoma or microadenoma, hypothalamic tumor (surgical removal of a pituitary tumor can also suppress production of ACTH and lead to adrenal deficiency); Sheehan's syndrome, which is associated with impairment of only the pituitary gland.
  • Tertiary adrenal insufficiency is due to hypothalamic disease and decrease in corticotropin releasing factor (CRF).

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