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Adrenal Disorders

  • Alois Gessl
  • Rosa Lemmens-Gruber
  • Alexandra Kautzky-Willer
Chapter
Part of the Handbook of Experimental Pharmacology book series (HEP, volume 214)

Abstract

The most frequent cause nowadays is autoimmune adrenalitis, which can be confirmed by the presence of 21-hydroxylase-antibodies (Oelkers 1996). When suspected on clinical grounds, adrenal insufficiency has to be confirmed by inappropriately low serum cortisol with elevated adrenocorticotropin (ACTH) (in case of primary adrenal insufficiency). A morning plasma cortisol ≤3 μg/dl is indicative for adrenal failure, whereas a cortisol ≥19 μg/dl rules out the disorder (Grinspoon and Biller 1994) if corticosterone-binding globulin (CBG) is normal. All other patients need dynamic testing (short ACTH stimulation test). A low ACTH in the presence of low cortisol points to secondary adrenal failure, in which case ACTH stimulation might be less reliable, especially when of recent onset.

Keywords

Glucocorticoid Receptor Adrenal Insufficiency Congenital Adrenal Hyperplasia Mineralocorticoid Receptor Adrenal Failure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

11b-HSD2

11β-hydroxysteroid-dehydrogenase

ACTH

Adrenocorticotropin

BCRP1

Breast cancer-resistance protein

BETA

Betamethasone

CAH

Congenital adrenal hyperplasia

CBG

Corticosterone-binding globulin

DEX

Dexamethasone

DHEA

Dehydroepiandrosterone

GR

Glucocorticoid receptor

MR

Mineralocorticoid receptor

sGC

Synthetic glucocorticoid

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Alois Gessl
    • 1
  • Rosa Lemmens-Gruber
    • 2
  • Alexandra Kautzky-Willer
    • 3
  1. 1.Division of Endocrinology and Metabolism, Department of Internal Medicine IIIMedical University of ViennaViennaAustria
  2. 2.Department of Pharmacology and ToxicologyUniversity of ViennaViennaAustria
  3. 3.Gender Medicine Unit, Department of Internal Medicine IIIMedical University of ViennaViennaAustria

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