Adrenal insufficiency.

Hahner, Stefanie, Ross, Richard J, Arlt, Wiebke, Bancos, Irina, Burger-Stritt, Stephanie, Torpy, David J, Husebye, Eystein S and Quinkler, Marcus (2021) Adrenal insufficiency. Nature reviews. Disease primers, 7 (1). p. 19. ISSN 2056-676X. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: http://www.nature.com/nrdp/

Abstract

Adrenal insufficiency (AI) is a condition characterized by an absolute or relative deficiency of adrenal cortisol production. Primary AI (PAI) is rare and is caused by direct adrenal failure. Secondary AI (SAI) is more frequent and is caused by diseases affecting the pituitary, whereas in tertiary AI (TAI), the hypothalamus is affected. The most prevalent form is TAI owing to exogenous glucocorticoid use. Symptoms of AI are non-specific, often overlooked or misdiagnosed, and are related to the lack of cortisol, adrenal androgen precursors and aldosterone (especially in PAI). Diagnosis is based on measurement of the adrenal corticosteroid hormones, their regulatory peptide hormones and stimulation tests. The goal of therapy is to establish a hormone replacement regimen that closely mimics the physiological diurnal cortisol secretion pattern, tailored to the patient's daily needs. This Primer provides insights into the epidemiology, mechanisms and management of AI during pregnancy as well as challenges of long-term management. In addition, the importance of identifying life-threatening adrenal emergencies (acute AI and adrenal crisis) is highlighted and strategies for prevention, which include patient education, glucocorticoid emergency cards and injection kits, are described.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QZ Pathology. Oncology
WD Diseases and disorders of systemic, metabolic or environmental origin
WD Diseases and disorders of systemic, metabolic or environmental origin > WD250 Metabolic diseases
WD Diseases and disorders of systemic, metabolic or environmental origin > WD350 Immunologic diseases
WK Endocrine system. Endocrinology
Divisions: Ambulatory Care > Endocrinology
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Depositing User: Jamie Edgar
Date Deposited: 26 Mar 2021 13:11
Last Modified: 26 Mar 2021 13:11
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4140

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