The hypothalamic–pituitary–adrenal axis has an importantrole in the body's ability to cope with stresses such as infections,hypotension, and surgery. The hypothalamus is subject to regulatoryinfluences from other parts of the brain, especially the limbicsystem. The hypothalamic hormones corticotropin-releasing hormoneand arginine vasopressin are important stimulants of corticotropinsecretion by the anterior pituitary. In this gland, the actionof the hypothalamic hormones is amplified so that a much largernumber of corticotropin molecules is secreted. Similarly, inthe adrenal cortex the action of corticotropin is amplified;a plasma corticotropin concentration of approximately 25 pgper milliliter (5.5 . . . [Full Text of this Article]
Causes
Primary Adrenal Insufficiency
Secondary Adrenal Insufficiency
Clinical Manifestations
Chronic Adrenal Insufficiency
Acute Adrenal Insufficiency
Laboratory Evaluation of Adrenal Function
Basal Hormone Measurements
Adrenal Autoantibody Tests
Corticotropin Stimulation Tests
Tests Involving Insulin-Induced Hypoglycemia, Metyrapone, and Corticotropin-Releasing Hormone
Radiologic Evaluation
Treatment
Replacement Therapy
Emergency Therapy
Conclusions
Source Information
From the Division of Endocrinology, Department of Medicine, Klinikum Benjamin Franklin, Freie Universität Berlin, Berlin, Germany.
Address reprint requests to Dr. Oelkers at Klinikum Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
References
Related Letters:
Adrenal Insufficiency
Bromberg J. S., Fabrega A. J., Corwin C., Martin M., Pepper G. M., Oelkers W.
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N Engl J Med 1997;
336:1105-1107, Apr 10, 1997.
Correspondence
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