Causes and clinical manifestations of central adrenal insufficiency in children
- Patricia A Donohoue, MD
Patricia A Donohoue, MD
- Professor of Pediatrics
- Medical College of Wisconsin
Adrenal insufficiency is defined by the impaired synthesis and release of adrenocortical hormones. It is classified based upon the mechanism:
●Primary adrenal insufficiency results from disease intrinsic to the adrenal cortex.
●Central adrenal insufficiency can be caused by impaired production or action of adrenocorticotropic hormone (ACTH). It can be caused by several mechanisms:
•Secondary adrenal insufficiency results from pituitary disease impairing release of ACTH.
•Tertiary adrenal insufficiency results from the impaired release or effect of corticotropin-releasing hormone (CRH) from the hypothalamus, which in turn impairs ACTH secretion.
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- CLINICAL MANIFESTATIONS
- SECONDARY ADRENAL INSUFFICIENCY
- - Congenital causes
- - Acquired causes
- Isolated ACTH deficiency
- Mimics of secondary adrenal insufficiency
- TERTIARY ADRENAL INSUFFICIENCY
- Hypopituitarism due to impaired hypothalamic function
- - Congenital causes
- - Acquired causes
- Isolated ACTH deficiency from suppressed hypothalamic function
- - Cessation of glucocorticoid therapy
- - Maternal glucocorticoid therapy
- - Resection of adrenal tumor
- SOCIETY GUIDELINE LINKS