ReviewFrontiers in endocrinology2021
Latent Adrenal Insufficiency: From Concept to Diagnosis.
Review in Frontiers in endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 26 citations in OpenAlex.
- Adrenal abscesses: an uncommon and unexpected cause of the acute abdomen.Emergency radiology · 2026Review
- Skeletal Microstructure in Addison's Disease.Journal of the Endocrine Society · 2026Article
- Primary adrenocortical insufficiency in patients with AIDS in Wuhan, China: 3 cases report and literature review.BMC infectious diseases · 2025Review
- Cortisol as a Predictor of Nocturnal Hypoglycemia in Insulin-Treated Diabetes: A Cross-Sectional Study.Cureus · 2025Article
- Cognitive Impairment Caused by Isolated Adrenocorticotropic Hormone Deficiency Mimicking Dementia with Lewy Bodies.Internal medicine (Tokyo, Japan) · 2025Article
- Hypopituitarism presenting with cardiovascular manifestations: a case report.BMC cardiovascular disorders · 2025Article
- Primary adrenal insufficiency developed 22 years after the diagnosis of light and heavy chain deposition disease: a case report.CEN case reports · 2024Article
- Endocrine Petrified Ear: Associated Endocrine Conditions in Auricular Calcification/Ossification (A Sample-Focused Analysis).Diagnostics (Basel, Switzerland) · 2024Review
- Acute Heart Failure as a First Manifestation of Primary Adrenal Insufficiency: Highly Lethal If Not Diagnosed!Case reports in endocrinology · 2024Article
- Autoimmune adrenal insufficiency in children: a hint for polyglandular syndrome type 2?Italian journal of pediatrics · 2023Article
- Adrenal Abscesses: A Systematic Review of the Literature.Journal of clinical medicine · 2023Review
- Evaluation of the effect of glucocorticoid treatment on adrenocortical functions by monitoring endogenous hydrocortisone in horses.The Journal of veterinary medical science · 2023Article
- Newly diagnosed autoimmune Addison's disease in a patient with COVID-19 with autoimmune disseminated encephalomyelitis.BMJ case reports · 2022Article
- Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Primary adrenal insufficiency (PAI) is a rare disease and potentially fatal if unrecognized. It is characterized by destruction of the adrenal cortex, most frequently of autoimmune origin, resulting in glucocorticoid, mineralocorticoid, and adrenal androgen deficiencies. Initial signs and symptoms can be nonspecific, contributing to late diagnosis. Loss of zona glomerulosa function may precede zona fasciculata and reticularis deficiencies. Patients present with hallmark manifestations including fatigue, weight loss, abdominal pain, melanoderma, hypotension, salt craving, hyponatremia, hyperkalemia, or acute adrenal crisis. Diagnosis is established by unequivocally low morning serum cortisol/aldosterone and elevated ACTH and renin concentrations. A standard dose (250 µg) Cosyntropin stimulation test may be needed to confirm adrenal insufficiency (AI) in partial deficiencies. Glucocorticoid and mineralocorticoid substitution is the hallmark of treatment, alongside patient education regarding dose adjustments in periods of stress and prevention of acute adrenal crisis. Recent studies identified partial residual adrenocortical function in patients with AI and rare cases have recuperated normal hormonal function. Modulating therapies using rituximab or ACTH injections are in early stages of investigation hoping it could maintain glucocorticoid residual function and delay complete destruction of adrenal cortex.
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