![]() ![]() ![]() Hyperkalemia does not occur since secretion of mineralocorticoids is not impaired, as it depends to a greater degree on the renin-angiotensin system than on ACTH, and orthostatic hypotension is less common. A key difference is the lack of skin hyperpigmentation, due to ACTH and melanocyte-stimulating hormone ( MSH) deficits. Symptoms are similar to those in Addison disease (primary AI) but usually develop more slowly and are less severe. Less frequent causes: Pituitary infarction/hemorrhage/apoplexy, postpartum pituitary hemorrhage (Sheehan syndrome: see Hypopituitarism), sellar neoplasms, sellar cystic lesions, immunotherapy, infiltrative (eg, hemochromatosis, sarcoidosis, histiocytosis X), infection/abscess, posttraumatic lesions/acquired brain injury, opioid use, hypophysitis, empty sella, congenital causes. Most frequent causes: Inhibition of ACTH secretion by long-term exogenous glucocorticoid therapy, high-dose opioids, large tumors of the pituitary, craniopharyngiomas, neurosurgical treatment of the pituitary, and parasellar tumors/lesions. PMID: 26760044 PMCID: PMC4880116.Ĭentral adrenal insufficiency ( AI) is a clinical syndrome caused by a long-term deficit of adrenal cortex hormones due to adrenocorticotropic hormone ( ACTH) deficiency. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. PMID: 33484633.īornstein SR, Allolio B, Arlt W, et al. Husebye ES, Pearce SH, Krone NP, Kämpe O. ![]()
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