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HYPOADRENALISM |
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1° adrenal disease [raised serum ACTH; skin pigmentation; hypotension]: |
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acquired (Addison's disease): |
autoimmune disease of adrenal glands [commonest cause in developed countries]tuberculosis [commonest cause world-wide]bilateral adrenalectomy metastatic carcinoma fungal infection amyloidosis haemochromatosis adrenal infarction or haemorrhage, eg. Waterhouse-Friderichsen syndrome in meningococcal septicaemia |
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congenital adrenal hyperplasia [various defects; features and severity vary] |
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2° adrenal insufficiency [low serum ACTH; blood pressure maintained; pallor]: |
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lesions of hypothalamus: |
tumour of 3rd ventricle trauma encephalitis idiopathic |
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lesions of stalk: |
optic glioma craniopharyngioma basal meningitis section of stalk |
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hypopituitarism: |
Sheehan's syndrome adenomas hypophysectomy radiation |
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steroid administration: |
[suppression of hypothalamic-pituitary-adrenal axis; hypoadrenalism occurs with acute illness or sudden withdrawal of steroids] |
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