c.Ĭentral AI: Normal/low ACTH, normal plasma renin activity (no impairment of mineralocorticoid function), low cortisol, normal aldosterone, hyponatremia, hypoglycemia. Primary AI: Elevated ACTH, elevated plasma renin activity, low cortisol, low aldosterone, hypoglycemia, hyponatremia, hyperkalemia. In central AI, there is only deficient glucocorticoid production, and mineralocorticoid production is normal. In primary AI, there is deficient mineralocorticoid and glucocorticoid production. Laboratory findings in adrenal insufficiency: a. NOTE: This is the most common cause seen in clinical practice and may also occur in setting of chronic high-dose inhaled corticosteroids. d.Īcquired insufficiency secondary to long-term corticosteroid use leading to HPA suppression.
Secondary AI caused by impaired circulating adrenocorticotropic hormone (ACTH) due to hypothalamic or pituitary pathology. b.Īdrenal destruction or dysfunction as in primary adrenal insufficiency (AI) (Addison disease), autoimmune polyendocrine syndrome, or adrenoleukodystrophy. Impaired steroidogenesis, as in congenital adrenal hyperplasia.
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