Insuficiencia suprarrenal primaria

Abstract

Adrenal insufficiency may affect both glucocorticoid and mineralocorticoid secretion (primary adrenal insufficiency) or only glucocorticoid production (central adrenal insufficiency). In developed countries most cases of primary adrenal insufficiency result from an autoimmune insult that may occur in association with other autoinmune endocrine disorders (polyglandular autoimmune syndromes). Early diagnosis is essential to avoid life-threating complications such as adrenal crisis. After biochemical diagnosis, it is important to establish the origin of the defect. Hyperpigmentation and hyperpotasemia are typical of primary adrenal insufficiency. High ACTH levels confirm this diagnosis. Treatment usually lead to normal quality of life, yet patients have to increase glucocorticoid doses when infection, trauma or physical or psychological stress occur. Treatment of adrenal crisis should not be delayed while diagnostic test are performed, since waiting for the confirmation of the diagnosis could be fatal.