Diagnosis and Treatment of Primary Adrenal Insufficiency
Publication Date: February 1, 2016
Last Updated: March 30, 2022
Diagnosis
Who Should Be Tested and How
The Endocrine Society (ES) recommends diagnostic testing to exclude PAI in acutely ill patients with otherwise unexplained symptoms or signs suggestive of PAI (volume depletion, hypotension, hyponatremia, hyperkalemia, fever, abdominal pain, hyperpigmentation or, especially in children, hypoglycemia). ( 1-M )
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ES recommends confirmatory testing with the corticotropin stimulation test in patients with clinical symptoms or signs suggesting PAI when the patient’s condition and circumstance allow. ( 1-H )
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Treatment
Treatment of Primary Adrenal Insufficiency in Adults
In patients with severe adrenal insufficiency symptoms or adrenal crisis, ES recommends IMMEDIATE therapy with IV hydrocortisone at an appropriate stress dose prior to the availability of the results of diagnostic tests ( 1-M )
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Title
Diagnosis and Treatment of Primary Adrenal Insufficiency