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Adrenal insufficiency - Recognition and management

Lookup NU author(s): Dr Agnieszka Pazderska, Professor Simon PearceORCiD


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© Royal College of Physicians 2017. All rights reserved. Adrenal insufficiency is characterised by inadequate glucocorticoid production owing to destruction of the adrenal cortex or lack of adrenocorticotropic hormone stimulation. In primary adrenal insufficiency, lack of mineralocorticoids is also a feature. Patients can present with an insidious onset of symptoms, or acutely in adrenal crisis, which requires prompt recognition and treatment. Chronic glucocorticoid therapy is the most common cause of adrenal insufficiency. The diagnosis of adrenal insufficiency is made by demonstrating low basal and/or stimulated serum cortisol and should be followed by appropriate investigations to establish the underlying aetiology. Maintenance glucocorticoid replacement is usually given as a twice or thrice daily hydrocortisone preparation. Patients with primary adrenal insufficiency also require mineralocorticoid. Regular monitoring for features of under-and over - replacement is essential during follow-up. Patient education is a key feature of management of this condition.

Publication metadata

Author(s): Pazderska A, Pearce SHS

Publication type: Article

Publication status: Published

Journal: Clinical Medicine

Year: 2017

Volume: 17

Issue: 3

Pages: 258-262

Print publication date: 01/06/2017

Acceptance date: 02/04/2016

ISSN (print): 1470-2118

ISSN (electronic): 1473-4893

Publisher: Royal College of Physicians

URL: 10.7861/clinmedicine.17-3-258

DOI: 10.7861/clinmedicine.17-3-258


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