endocrine and metabolic disorders
Secondary Adrenal Insufficiency
Key Points
Secondary adrenal insufficiency involves adrenocorticotropic hormone (ACTH) deficiency due to pituitary or, less often, hypothalamic causes (including suppression by long-term corticosteroid use). Other endocrine deficiencies (eg, hypothyroidism, growth hormone deficiency) may coexist. Unlike in Addison disease, hyperpigmentation does not occur and serum sodium and potassium levels are relatively normal. ACTH and cortisol levels both are low. Glucocorticoid replacement is required, but mineralocorticoids (eg,fludrocortisone) are not necessary. 