Relevant Physiology

Etiology

• Autoimune (”Idiopathtic”) → PMHx, FMHX, anti-body test
• Infectious
• Bilateral adrenal hemorrhage/infarction → Abdominal CT
• Congenital adrenal hyperplasia → 17-OH Progesterone Level = high
• Adrenoleukodystrophy → VLCFA Level = high
  • Adrenoleukodystrophy
• Secondary or Tertiary → ACTH = high

Pathogenesis

• Destruction of the zona glomerulosa and zona fasciulata

• Affect both cortisol and aldosterone axis

• Cortisol Effect

Consequences/Natural history

• Can advance to !Addisonian crisis → fatal if untreated

Presentation

Signs and Symptoms

Risk factors

DDx