Abstract

Since Thomas Addison first reported adrenal insufficiency in the 19th century till nowadays still this entity shows challenging scenarios and recurrently reported as missed cases diagnosed retrograde after substantial delay. This is due to the wide variety and non-specific manifestations such as fatigue, malaise, loss of energy, loss of appetite and even occasionally present with mood disorders. Also there are exceptions for cardinal features of adrenal insufficiency such as absent pigmentation in secondary and some primary cases of Adrenal Insufficiency (A.I) and the cosyntropin test may give normal response if done early in secondary A.I. So in this article there is extensive literature review of the adrenal insufficiency covering a wide spectrum of areas starting from physiology back ground till the management lines and raising some important points such as the regenerative potential of the adrenal glands, the variety of presentations, the entity of pseudo-hypoadrenalism, some pitfalls in the diagnosis, possible self-recovery and management lines.

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