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.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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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
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