Adrenal Insufficiency - Aetiology, Diagnosis and Treatment

Authors

  • Nazma Akter Resident Physician, Dept. of Medicine, Marks Medical College & Hospital, Dhaka
  • Nazmul Kabir Qureshi Specialist, Dept. of Medicine, United Hospital Limited, Dhaka

DOI:

https://doi.org/10.3329/dmcj.v3i1.22238

Keywords:

Adrenal insufficiency, glucocorticoid

Abstract

Adrenal insufficiency is caused by either primary adrenal failure or by hypothalamic-pituitary impairment of the corticotropic axis. Adrenal insufficiency, first codified in 1855 by Thomas Addison, remains relevant in 2014 because of its lethal nature. Though, it is a rare disease but is life threatening when overlooked. Main presenting symptoms such as fatigue, anorexia and weight loss are nonspecific, thus diagnosis is often delayed. The diagnostic work-up is well established but some pitfalls remain. The diagnosis is adequately established by the 250 ?g ACTH (adrenocorticotropic hormone) stimulation test in most cases. Glucocorticoids provide life saving treatment but long-term quality of life is impaired, perhaps because therapy is not given in a physiologic way. Dehydroepiandrosterone-replacement therapy has been introduced that could help to restore quality of life. It may be useful in pubertal girls, but not in adults. Monitoring of glucocorticoid-replacement is difficult due to lack of objective methods of assessment and is therefore largely based on clinical grounds. Thus, long-term management of patients with adrenal insufficiency remains a challenge, requiring an experienced specialist.

DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22238

Delta Med Col J. Jan 2015; 3(1): 36-47

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Abstract
1038
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Published

2015-02-14

How to Cite

Akter, N., & Qureshi, N. K. (2015). Adrenal Insufficiency - Aetiology, Diagnosis and Treatment. Delta Medical College Journal, 3(1), 36–47. https://doi.org/10.3329/dmcj.v3i1.22238

Issue

Section

Review Articles