Adrenal Insufficiency

The clinical presentation of adrenal insufficiency is variable and depends on whether the onset is acute (leading to adrenal crisis) or chornic, with symptoms that are often vague and insidious. The key to making the diagnosis of adrenal insufficiency is a high level of clinical suspicion. The signs and symptoms of adrenal insufficiency depend upon the rate and extent of loss of adrenal function, whether mineralocorticoid production is preserved, and the degree of stress. The following is a list of key clinical features of primary adrenal insufficiency:

• weakness


• fatigue


• anorexia


• orthostatic hypotension


• nausea


• vomiting

The following is a list of key laboratory abnormalities of primary adrenal insufficiency:

• hyponatremia


• hyperkalemia


• hypoglycemia


• lymphocytosis


• eosinophilia


• hypercalcemia (rarely)