Julkaistu 16.12.2011 00.01 Adrenal insufficiency was first
described by Thomas Addison in 1855. Although a rare disease it
is still a life-threatening condition when presenting as an
acute adrenal crisis. Primary adrenal insufficiency is most
often caused by autoimmune adrenalitis and secondary adrenal
insufficiency by pituitary tumours. Patients with primary
adrenal insufficiency typically develop gradual cortisol and
aldosterone deficiency and may initially be symptomatic only
during stress. The diagnosis is therefore often delayed. Common
features and signs are fatigue, weight loss, nausea, salt
craving, hyperpigmentation and hypotension. In contrast,
patients with secondary adrenal insufficiency suffer from
cortisol deficiency only and are not characterized by
hyperpigmentation or salt craving. Patients with primary adrenal
insufficiency require life-long replacement therapy with
hydrocortisone and fludrocortisone and patients with secondary
adrenal deficiency hydrocortisone substitution. Patients with ad