What is the most common cause of adrenal insufficiency?

What is the most common cause of adrenal insufficiency?

• A. Autoimmune
• B. Infections TB
• C. Adrenal hemorrhage
• D. Chronic steroid withdrawal

Answer: (A)

Autoimmune destruction of the adrenal cortex is the most common cause of primary adrenal insufficiency in the developed world. This autoimmune adrenalitis gradually erodes the adrenal cortex, reducing production of both cortisol and often aldosterone. The lack of cortisol (and aldosterone) leads to fatigue, weight loss, nausea, low blood pressure, hyponatremia, and hyperkalemia; hyperpigmentation can occur due to high ACTH stimulating melanocytes. Lab clues include an elevated ACTH with a blunted or absent cortisol response to ACTH stimulation. Autoimmune etiologies are frequently associated with other autoimmune endocrinopathies, forming polyglandular syndromes. While TB and other infections have historically caused adrenal insufficiency, especially in certain regions worldwide, autoimmune destruction is the most common cause in many exam populations. Adrenal hemorrhage is a less common acute cause, and chronic steroid withdrawal causes secondary (not primary) adrenal insufficiency due to HPA-axis suppression rather than destruction of the adrenal cortex.

Autoimmune destruction of the adrenal cortex is the most common cause of primary adrenal insufficiency in the developed world. This autoimmune adrenalitis gradually erodes the adrenal cortex, reducing production of both cortisol and often aldosterone. The lack of cortisol (and aldosterone) leads to fatigue, weight loss, nausea, low blood pressure, hyponatremia, and hyperkalemia; hyperpigmentation can occur due to high ACTH stimulating melanocytes. Lab clues include an elevated ACTH with a blunted or absent cortisol response to ACTH stimulation. Autoimmune etiologies are frequently associated with other autoimmune endocrinopathies, forming polyglandular syndromes. While TB and other infections have historically caused adrenal insufficiency, especially in certain regions worldwide, autoimmune destruction is the most common cause in many exam populations. Adrenal hemorrhage is a less common acute cause, and chronic steroid withdrawal causes secondary (not primary) adrenal insufficiency due to HPA-axis suppression rather than destruction of the adrenal cortex.