Causes of adrenal insufficiency can be grouped by the way they cause the adrenals to produce insufficient cortisol.
These are ''adrenal dysgenesis'' (the gland has not formed adequately during development), ''impaired steroidogenesis'' (the gland is present but is biochemically unable to produce cortisol) or ''adrenal destruction'' (disease processes leading to the gland being damaged).
This may be isolated or in the context of autoimmune polyendocrine syndrome (APS type 1 or 2), in which other hormone-producing organs such as the thyroid and pancreas may also be affected.
Adrenal destruction is also a feature of adrenoleukodystrophy (ALD), and when the adrenal glands are involved in metastasis (seeding of cancer cells from elsewhere in the body, especially lung), hemorrhage (e.g. in Waterhouse-Friderichsen syndrome or antiphospholipid syndrome), particular infections (tuberculosis, histoplasmosis, coccidioidomycosis), deposition of abnormal protein in amyloidosis.
Further Reading
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"Addison's disease"
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