Adrenal insufficiency is a syndrome caused by a primary adrenal cortex disorder (Addison's disease) or secondary changes due to decreased secretion of ACTH; manifests symptoms of decreased production of hormones of the adrenal cortex. Distinguish between chronic and acute adrenal insufficiency, according to the Internet edition for girls and women from 14 to 35 years old Pannochka. net Causes of adrenal insufficiency Primary adrenal insufficiency is caused by tuberculosis (in 40% of cases) or atrophy of the adrenal cortex caused by autoimmune processes (in 50% of cases).

More rare causes - bilateral adrenalectomy, thrombosis or embolism of adrenal vessels. In patients with immunodeficiency, for example, with AIDS, a fungal infection of the adrenal cortex is possible. A common cause of acute adrenal insufficiency is meningococcal infection.

The cause of secondary insufficiency may be postnatal necrosis of the pituitary (Shihan syndrome), pituitary tumors, hypophysectomy, craniopharyngiomas. Another common cause of secondary adrenal insufficiency is long-term treatment with glucocorticoids, for example, about autoimmune diseases.

Reduced secretion of cortisol leads to a violation of protein and carbohydrate, and aldosterone deficiency - to the violation of mineral metabolism.

Symptoms of adrenal insufficiency The main clinical symptoms of primary hypokorticism (Addison's disease) are: hyperpigmentation of the skin and mucous membranes, weight loss, general weakness, asthenia, depression, decreased libido, arterial hypotension, dyspeptic disorders, addiction to salty foods.

Diagnosis of adrenal insufficiency Diagnosis is based on a decrease in the baseline level of 17-ACS in urine and plasma, as well as a preserved response to ACTH.

Treatment of adrenal insufficiency Treatment of primary and secondary adrenal insufficiency consists in the introduction of hormones of the adrenal cortex. Apply prednisolone (prednisone) to 5-10 mg or cortisone for 25-50 mg per day; combinations of prednisolone and cortisone are recommended; 2 / d doses of hormones taken inside the morning and 1/3 - in the afternoon (after eating). If the blood pressure is not normalized, add 5 mg of desoxycorticosterone acetate in an oily solution of IM daily, every other day or twice a week, or in tablets 5 mg 1-3 times daily under the tongue.

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