II. Pathophysiology

  1. Hypothalamic-Pituitary-Adrenal Axis (HPA) Dysfunction
    1. Lab features: Cortisol low, ACTH Low
    2. Causes
      1. Severe illness
      2. Exogenous Corticosteroid (suppression lasts months)
        1. Prednisone >7.5 mg/day for >3 weeks
        2. Dexamethasone >0.75 mg/day for >3 weeks
      3. Pituitary Infarction
      4. CNS Infection or tumor invasion
      5. Head Injury
      6. HIV Infection
  2. Adrenal Insufficiency
    1. Lab features: Cortisol low, ACTH high
    2. Causes
      1. Addison's Disease (Primary Adrenal Insufficiency)
        1. Primary adrenal failure of Adrenal Glands
          1. Mineralcorticoid deficiency
          2. Glucocorticoid deficiency
          3. Adrenal androgen deficiency
        2. Adrenal cortical destruction via Autoimmunity
          1. Isolated Adrenal Insufficiency or
          2. Component of Autoimmune Polyglandular Syndrome
      2. Idiopathic adrenal hypoplasia or destruction
        1. Granulomatous disease (e.g. Tuberculosis, Fungus)
        2. Amyloidosis
        3. Hemochromatosis
        4. Tumor
        5. Autoimmune Dystruction
      3. Drug mediated cortisol inhibition
        1. Etomidate
        2. Ketoconazole

III. Epidemiology

  1. Prevalence: 1 per 20,000 in U.S. and western europe

IV. Stages: Autoimmune Adrenalitis

  1. Stage 1: Predisposing genetic risk
    1. HLA-B8
    2. HLA-DR3
    3. HLA-DR-4
  2. Stage 2: Precipitating trigger
    1. Environmental event such as viral infection
  3. Stage 3: Formation of 21-Hydroxylase Antibody
    1. Precedes symptoms and signs in 90% of cases
  4. Stage 4: Overt Adrenal Insufficiency (Metabolic Decompensation)
    1. Presents with Fatigue, anorexia, Nausea, volume depletion and Hyperpigmentation
    2. Lab findings consistent with Addison's Disease (Increased ACTH, decreased 8 am Serum Cortisol)
  5. Stage 5: ACTH decreased response
    1. Addisonian Crisis presents with life-threatening Hypotension and shock
    2. May be unmasked by acute stress or illness
    3. Typically limited to primary Adrenal Insufficiency (as opposed to secondary Adrenal Insufficiency)

V. Symptoms

  1. Course
    1. Typically insidious course over years (making diagnosis difficult and cryptic)
  2. Constitutional (100% of cases)
    1. Anorexia or weight loss
    2. Weakness
    3. Fatigue or Lethargy
  3. Gastrointestinal symptoms (92% of cases)
    1. Nausea or Vomiting
    2. Diarrhea
    3. Abdominal Pain
  4. Miscellaneous symptoms
    1. Salt craving (16% of cases)
    2. Altered Level of Consciousness (e.g. Delirium)
    3. Postural Dizziness (12% of cases)
    4. Myalgias or arthralgias (10% of cases)

VI. Signs

  1. Fever
  2. Reduced Hair Growth
  3. Hyperpigmentation (94% of cases)
    1. Only occurs with primary Adrenal Insufficiency
      1. Results from hyperstimulation of anterior pituitary Corticotrophs
      2. Cross-reactivity with Melatonin I receptor on Keratinocytes
    2. Skin with mottled areas of increased pigmentation
    3. Increased pigment in vermilion border of lips, vagina, Rectum as well as palmar creases, Buccal mucosa (Caucasian), nipples and scars
    4. Opposite findings of Vitiligo may occur in up to 10-20% of cases
  4. Hypotension (especially Postural Hypotension)
    1. Systolic Blood Pressure <110 mmHg in 90% of cases
    2. Signs of volume depletion or dehydration

VII. Labs

  1. Complete Blood Count
    1. Normochromic Normocytic Anemia
    2. Eosinophilia (helps differentiate from other causes)
  2. Serum electrolytes
    1. Hyponatremia (88%)
    2. Hypochloremia
    3. Hyperkalemia (64%)
    4. Hypercalcemia (<33%)
    5. Hypoglycemia (67%)
      1. Helps differentiate from other causes
  3. Adrenal labs used in the diagnosis of Adrenal Insufficiency
    1. Serum Cortisol at 8 am (see diagnosis below)
    2. Corticotropin Stimulation Test (see diagnosis below)
    3. 21-hydroxylase Antibody
    4. ACTH
  4. Other adrenal labs
    1. Thyroid Stimulating Hormone (TSH)
      1. Increased TSH levels <30 mIU/L may normalize with treatment of Addison Disease
      2. Avoid Thyroid Replacement until Addison Disease excluded or treated (risk of Addisonian Crisis)
    2. Urine 17-ketosteroids low
    3. Urine 17-Hydroxysteroids low
  5. Other findings
    1. Plasma renin increased (early marker in Adrenal Insufficiency)

VIII. Associated Conditions: Autoimmune disorders

  1. At least one comorbid autoimmune condition accompanies Addison Disease in 50% of cases
  2. Hashimoto's Thyroiditis or Graves Disease (22% lifetime Prevalence)
    1. Thyroid Hormone Replacement in a patient with untreated Addison Disease may result in Addisonian Crisis
  3. Celiac Sprue (12% lifetime Prevalence)
  4. Type I Diabetes Mellitus (11% lifetimes Prevalence)
    1. Addison Disease may present in those with Type I Diabetes as decreased insulin Requirements and Hypoglycemia
  5. Hypoparathyroidism (10% lifetime Prevalence)
  6. Premature Ovarian Failure (10% lifetime Prevalence)
  7. Pernicious Anemia (5% lifetime Prevalence)
  8. Primary gonadal failure (2% lifetime Prevalence)

IX. Diagnosis

  1. Initial screening (indications for Corticotropin Stimulation Test)
    1. Serum Cortisol level at 8 am decreased to <3 mcg/dl
    2. Serum Potassium increased in mineralcorticoid deficiency
    3. Serum Sodium decreased in cortisol deficiency or mineralcorticoid deficiency
    4. Plasma renin increased (early finding of adrenal cortical dysfunction)
    5. ACTH increased >50 pg/ml
  2. Corticotropin Stimulation Test (Cosyntropin Stimulation Test)
    1. Failed adrenal response (Serum Cortisol) to 250 mcg IV ACTH at 30 -60 minutes
    2. Low cortisol (<18 mcg/dl) and low ACTH level suggests secondary Adrenal Insufficiency
    3. Low cortisol (<18 mcg/dl) and high ACTH level suggests primary Adrenal Insufficiency (Addison's Disease)
      1. Obtain 21-hydroxylase Antibody level (suggests Autoimmune Adrenalitis)
      2. Obtain CT Abdomen of the Adrenal Glands (indicated when secondary Adrenal Insufficiency is considered)
        1. Adrenal Glands are small in Autoimmune Adrenalitis
        2. May demonstrate secondary cause such as adrenal tumor or Tuberculosis infiltration

X. Management

  1. Acute Addisonian Crisis (initial severe, life-threatening presentation)
    1. Hydrocortisone 100 mg IV every 6 hours (or Dexamethasone 4 mg IV) AND
    2. Fludrocortisone 0.1 mg daily AND
    3. Correct electrolyte abnormalities AND
    4. Monitor Glucose closely and correct Hypoglycemia (D50 in adults)
  2. Acute stressors (e.g. illness or surgery)
    1. See Stress Dose Steroid
  3. Chronic, life-long adrenal replacement
    1. Standard Glucocorticoid replacement (select one)
      1. Prednisone 3-5 mg orally daily
      2. Hydrocortisone 15-25 mg/day divided 2-3 times daily
    2. Backup Glucocorticoid replacement (for home IM use, when unable to tolerate oral medications)
      1. Dexamethasone 0.5 mg oral, IM or IV once daily
    3. Mineralcorticoid replacement
      1. Fludrocortisone 0.05 to 0.2 mg daily
      2. Consider increased dose for seasons with increased sweat loss
      3. Adjust based on Serum Sodium, Serum Potassium, Blood Pressure and plasma renin activity
    4. Androgen Replacement (optional)
      1. Dehydroepiandrosterone (DHEA) 25-50 mg daily (OTC supplement)
      2. Consider for improved mood and libido (especially in women)

XI. Resources

  1. National Adrenal Diseases Foundation
    1. http://www.nadf.us

Images: Related links to external sites (from Google)

Ontology: Addison Disease (C0001403)

Definition (NCI) A hormonal disorder that occurs when the adrenal glands fail to release adequate amounts of glucocorticoids (cortisol), mineralocorticoids (aldosterone, 11-deoxycorticosterone), and androgens (dehydroepiandrosterone) to meet physiologic needs, despite release of ACTH from the pituitary.
Definition (MEDLINEPLUS)

Your adrenal glands are just above your kidneys. The outside layer of these glands makes hormones that help your body respond to stress and regulate your blood pressure and water and salt balance. Addison's disease occurs if the adrenal glands don't make enough of these hormones.

A problem with your immune system usually causes Addison's disease. The immune system mistakenly attacks your own tissues, damaging your adrenal glands.

Symptoms include

  • Weight loss
  • Muscle weakness
  • Fatigue that gets worse over time
  • Low blood pressure
  • Patchy or dark skin

Lab tests can confirm that you have Addison's disease. If you don't treat it, it can be fatal. You will need to take hormone pills for the rest of your life. If you have Addison's disease, you should carry an emergency ID. It should say that you have the disease, list your medicines and say how much you need in an emergency.

Definition (MSH) An adrenal disease characterized by the progressive destruction of the ADRENAL CORTEX, resulting in insufficient production of ALDOSTERONE and HYDROCORTISONE. Clinical symptoms include ANOREXIA; NAUSEA; WEIGHT LOSS; MUSCLE WEAKNESS; and HYPERPIGMENTATION of the SKIN due to increase in circulating levels of ACTH precursor hormone which stimulates MELANOCYTES.
Definition (CSP) disease characterized by hypotension, weight loss, anorexia, weakness, and sometimes a bronze-like melanotic hyperpigmentation of the skin; due to tuberculosis or autoimmune induced disease (hypofunction) of the adrenal glands that results in deficiency of aldosterone and cortisol.
Concepts Disease or Syndrome (T047)
MSH D000224
ICD10 E27.1
SnomedCT 111562000, 367376006, 363732003, 373662000, 154707007, 267483004, 68588005
English Disease, Addison, ADDISON DISEASE, ADDISON'S DISEASE, ADRENAL INSUFFICIENCY (ADDISON'S DISEASE), ADRENOCORTICAL INSUFFICIENCY, PRIMARY FAILURE, DISEASE ADDISON'S, Addison's disease, NOS, Primary adrenal deficiency, Primary adrenocortical insuff, Disease Addison's, Adrenal insufficiency (Addison disease), ADDISONS DIS, ADDISON DIS, Chronic Adrenal Insufficiency, Hypocortisolism, Addison's disease NOS, primary adrenal insufficiency, primary adrenal insufficiency (diagnosis), Addison's disease, NOS (disorder), Addison Disease, Addison disease, Addison Disease [Disease/Finding], Disease;Addisons, addison disease, addison's disease, Primary adrenal insufficiency, Addison's disease, Primary adrenocortical insufficiency, Primary hypoadrenalism, Addison's disease (disorder), Primary adrenocortical insufficiency (disorder), corticoadrenal; deficiency, primary, deficiency; adrenocortical, primary, deficiency; corticoadrenal, primary, disease (or disorder); bronzed skin (Addison) (bronze disease), hypoadrenocorticism; primary, insufficiency; adrenal, primary, insufficiency; suprarenal, primary, adrenal cortex; deficiency, primary, adrenal cortex; hypofunction, primary, adrenal; insufficiency, primary, primary; hypoadrenocorticism, Addison; disease or syndrome, suprarenal; insufficiency, primary, syndrome; Addison, Addison's disease [Ambiguous], Addison's Disease, Hypoadrenalism, Primary, Hypoadrenalisms, Primary, Insufficiencies, Primary Adrenocortical, Insufficiency, Primary Adrenocortical, Primary Adrenal Insufficiency, Primary Adrenocortical Insufficiencies, Primary Adrenocortical Insufficiency, Primary Hypoadrenalism, Adrenal Insufficiency, Primary, Adrenocortical Insufficiencies, Primary, Adrenocortical Insufficiency, Primary, Addisons Disease, Addisons disease
Portuguese DOENCA DE ADDISON, Hipadrenalismo primário, Insuficiência suprarrenal primária, Doença de Addison
Italian Insufficienza surrenale primitiva, Malattia di Addison, Iposurrenalismo primitivo, Insufficienza corticosurrenale cronica, Insufficienza adrenocorticale primaria, Ipoadrenalismo primario, Morbo di Addison
Dutch primair hypoadrenalisme, ziekte van Addison, Addison; ziekte of syndroom, aandoening; bronzed skin (Addison) (bronsziekte), bijnier; insufficiëntie, primair, bijnierschors; deficiëntie, primair, bijnierschors; hypofunctie, primair, cortico-adrenaal; deficiëntie, primair, deficiëntie; bijnierschors, primair, deficiëntie; cortico-adrenaal, primair, hypoadrenocorticisme; primair, insufficiëntie; bijnier, primair, insufficiëntie; suprarenaal, primair, primair; hypoadrenocorticisme, suprarenaal; insufficiëntie, primair, syndroom; Addison, primaire bijnierinsufficiëntie, Addison, syndroom van, Addison, ziekte van, Ziekte van Addison, Primaire bijnierschorsinsufficiëntie
French Hyposurrénalisme, MALADIE D'ADDISON, Insuffisance surrénalienne primaire, Insuffisance corticosurrénalienne primitive, Insuffisance surrénalienne primitive, Maladie d'Addison, Insuffisance surrénale lente, Insuffisance surrénale primitive
German Krankheit Addisonsche, Addisonsche Krankheit, primaerer Hypoadrenalismus, MORBUS ADDISON, Primaere Nebennierenrindeninsuffizienz, primaere Nebenniereninsuffizienz, Addison-Krankheit, Bronzehautkrankheit, Nebenniereninsuffizienz, primär chronische
Spanish Hipoadrenalismo primario, Addison's disease, Addison's disease, NOS, ADDISON, ENFERMEDAD, enfermedad de Addison (concepto no activo), enfermedad de Addison (trastorno), enfermedad de Addison, insuficiencia adrenal crónica, insuficiencia adrenal primaria, insuficiencia adrenocortical primaria, insuficiencia corticosuprarrenal primaria (trastorno), insuficiencia corticosuprarrenal primaria, insuficiencia suprarrenal crónica, insuficiencia suprarrenal primaria, Insuficiencia suprarrenal primaria, Enfermedad de Addison
Japanese 原発性副腎機能不全, 原発性副腎機能低下症, ゲンパツセイフクジンキノウフゼン, アジソンビョウ, ゲンパツセイフクジンキノウテイカショウ, Addison病, アジソン病, 副腎性黒皮症, 副腎機能不全症-原発性, 原発性副腎機能不全症, 原発性副腎皮質機能低下症, 慢性副腎皮質不全症, アディソン病, 副腎皮質機能低下症-原発性
Swedish Addisons sjukdom
Czech Addisonova nemoc, Primární hypoadrenalismus, Primární nadledvinová nedostatečnost, Addisonova choroba
Finnish Addisonin tauti
Russian ADDISONOVA BOLEZN', BRONZOVAIA BOLEZN', АДДИСОНОВА БОЛЕЗНЬ, БРОНЗОВАЯ БОЛЕЗНЬ
Korean 원발성 부신피질 기능부전
Croatian ADDISONOVA BOLEST
Polish Choroba Addisona, Pierwotna przewlekła niedoczynność kory nadnerczy, Cisawica
Hungarian Addison-kór, Addison-betegség, Primaer mellékvese elégtelenség, Primaer hypadrenia

Ontology: Adrenal gland hypofunction (C0001623)

Definition (NCI) An endocrine or hormonal disorder that occurs when the adrenal cortex does not produce enough of the hormone cortisol and in some cases, the hormone aldosterone. It may be due to a disorder of the adrenal cortex (Addison's disease or primary adrenal insufficiency) or to inadequate secretion of ACTH by the pituitary gland (secondary adrenal insufficiency).
Definition (NCI) A disorder that occurs when the adrenal cortex does not produce enough of the hormone cortisol and in some cases, the hormone aldosterone. It may be due to a disorder of the adrenal cortex as in Addison's disease or primary adrenal insufficiency.
Definition (MSH) Conditions in which the production of adrenal CORTICOSTEROIDS falls below the requirement of the body. Adrenal insufficiency can be caused by defects in the ADRENAL GLANDS, the PITUITARY GLAND, or the HYPOTHALAMUS.
Definition (CSP) abnormally diminished activity of the adrenal gland.
Concepts Disease or Syndrome (T047)
MSH D000309
SnomedCT 237785004, 111563005, 386584007, 68588005, 190527008
English ADRENAL INSUFFICIENCY, HYPOADRENALISM, ADRENAL HYPOFUNCTION, HYPOFUNCTION ADRENAL, Hypofunction, Adrenal Gland, hypoadrenalism, Adrenal insufficiency, NOS, INSUFFICIENCY ADRENAL, adrenal insufficiency, adrenal insufficiency (diagnosis), Adrenal gland hypofunction, Hypofunction adrenal, Adrenal insufficiency NOS, Insufficiency adrenal, Adrenal Cortical Insufficiency, Adrenal Insufficiency [Disease/Finding], Insufficiency;adrenal, adrenal failure, adrenal hypofunctions, adrenal insufficiencies, insufficiency adrenal, adrenal hypofunction, Adrenal failure, Adrenal hypofunction, Adrenal insufficiency, Adrenal hypofunction (disorder), Hypoadrenalism (disorder), Adrenal Gland Hypofunction, Hypoadrenalism, Adrenal Insufficiencies, Adrenal Insufficiency, Adrenal Gland Insufficiency
French INSUFFISANCE SURRENALE, Hypofonction surrénalienne, Hypofonction surrénale, Insuffisance surrénalienne SAI, HYPOFONCTIONNEMENT SURRENAL, HYPOSURRENALISME, Insuffisance surrénale, Hypofonctionnement de la glande surrénale, Hypofonctionnement surrénalien, Insuffisance surrénalienne
German NEBENNIERENUNTERFUNKTION, Nebenniereninsuffizenz NNB, Insuffizienz Nebenniere, Hypoadrenalismus, Unterfunktion Nebenniere, HYPOADRENALISMUS, NEBENNIERENINSUFFIZIENZ, Nebenniereninsuffizienz, Hypokortizismus, Nebennierenunterfunktion
Italian Insufficienza surrenale, Ipofunzione surrenale, Insufficienza surrenale NAS, Iposurrenalismo, Ipoadrenalismo, Ipofunzione della ghiandola surrenale
Dutch hypofunctie bijnier, bijnierinsufficiëntie NAO, insufficiëntie bijnier, hypoadrenalisme, bijnierhypofunctie, bijnierinsufficiëntie, Bijnierhypofunctie, Hypocorticisme, Hypofunctie, bijnier-, Bijniermerginsufficiëntie, Bijnierschorsinsufficiëntie, Bijnierinsufficiëntie, Insufficiëntie, bijnier-
Portuguese Insuficiência supra-renal NE, Hipofunção supra-renal, Hipoadrenalismo, HIPOADRENALISMO, HIPOFUNCAO SUPRA-RENAL, INSUFICIENCIA SUPRA-RENAL, Insuficiência supra-renal, Hipofunção das Glândulas Supra-Renais, Insuficiência Adrenal, Insuficiência Supra-Renal
Spanish Insuficiencia suprarrenal NEOM, Insuficiencia adrenal, Hipofunción suprarrenal, Hipoadrenalismo, Adrenal hypofunction, HIPOADRENALISMO, INSUFICIENCIA SUPRARRENAL, SUPRARRENAL HIPOFUNCION, hipoadrenalismo (trastorno), hipoadrenalismo, hipofunción adrenal, hipofunción suprarrenal (trastorno), hipofunción suprarrenal, Insuficiencia suprarrenal, Hipofunción de las Glándulas Suprarrenales, Insuficiencia Suprarrenal, Hipofuncion de las Glandulas Suprarrenales
Japanese 副腎機能不全NOS, 副腎機能不全, フクジンキノウテイカ, フクジンキノウフゼンNOS, フクジンキノウテイカショウ, フクジンキノウフゼン, 副腎皮質機能低下症, 副腎機能低下, 副腎機能低下症, 副腎皮質機能低下
Swedish Binjurehypofunktion
Czech nadledviny - hypofunkce, Nedostatečnost nadledvin NOS, Nedostatečnost nadledvin, Adrenální hypofunkce, Adrenální nedostatečnost, Hypoadrenalismus, nadledviny - insuficience, insuficience nadledvin
Finnish Lisämunuaisen vajaatoiminta
Russian NADPOCHECHNIKOV NEDOSTATOCHNOST', NADPOCHECHNIKOV GIPOFUNKTSIIA, НАДПОЧЕЧНИКОВ ГИПОФУНКЦИЯ, НАДПОЧЕЧНИКОВ НЕДОСТАТОЧНОСТЬ
Croatian Not Translated[Adrenal Insufficiency]
Polish Niewydolność kory nadnerczy, Niedoczynność kory nadnerczy
Hungarian Mellékvese-elégtelenség, Adrenalis hypofunctio, Hypadrenia, Mellékvese elégtelenség, Mellékvese hypofunctio, Mellékvese-elégtelenség k.m.n.

Ontology: Addisonian crisis (C0151467)

Concepts Disease or Syndrome (T047)
ICD10 E27.2
SnomedCT 190522002, 190526004, 237757001, 24867002, 154707007, 267483004
English ADDISONIAN CRISIS, ADRENAL APOPLEXY, ADRENAL CRISIS, ADRENAL STORM, ADRENOCORTICAL INSUFFICIENCY, ACUTE, CRISIS ADDISONIAN, CRISIS ADRENAL, Addisonian crisis, Adrenal Apoplexy, Adrenocortical insufficiency syndrome, acute, Adrenal crisis syndrome, adrenal crisis (diagnosis), adrenal crisis, Adrenal storm, Acute adrenal insufficiency (& [Addisonian crisis] or [adrenal crisis]) (disorder), Addisonian crisis (disorder), Addisonian crisis (diagnosis), Adrenocortical insufficiency acute, Crisis addisonian, Crisis adrenal, acute adrenal insufficiency, addisonian crisis, adrenal storm, severe adrenal insufficiency, Adrenal crisis, Severe adrenal insufficiency, Acute adrenal insufficiency, Adrenocortical crisis, Severe adrenal insufficiency (disorder), collapse; adrenal, crisis; Addison, crisis; adrenal, adrenal; collapse, adrenal; crisis, adrenal; shock, Addison; crisis, shock; adrenal, Acute adrenal insufficiency (& [Addisonian crisis] or [adrenal crisis])
Italian Insufficienza corticosurrenale acuta, Crisi surrenale, Crisi Addisoniana, Crisi addisoniana, Tempesta surrenale
Dutch adrenale crisis, Addison-crisis, crisis bijnier, adrenale storm, Addison; crisis, adrenaal; crisis, bijnier; collaps, bijnier; shock, collaps; bijnier, crisis; Addison, crisis; adrenaal, shock; bijnier, acute bijnierschorsinsufficiëntie
French Crise d'Addison, Crise surrénale, Crise d'insuffisance surrénale, Crise surrénalienne, CATACLYSME SURRENAL, CRISE SURRENALE, Insuffisance surrénalienne aiguë
German Nebennierenkrise, Krise Nebenniere, Krise Addison, Addison-Krise, ADDISONKRISE, akute Nebennierenrindenueberfunktion, NEBENNIERENKRISE, Nebennierenrindeninsuffizienz akut
Portuguese Crise de Addison, Crise addisoniana, Crise supra-renal, Perturbação supra-renal, CRISE SUPRA-RENAL, Insuficiência adrenocortical aguda
Spanish Crisis adrenal, Crisis addisoniana, Addisonian crisis, Acute adrenal insufficiency (& [Addisonian crisis] or [adrenal crisis]), Acute adrenal insufficiency, Adrenal crisis, Tormenta adrenal, CRISIS SUPRARRENAL, SUPRARRENAL, CRISIS, crisis addisoniana, crisis suprarrenal, insuficiencia adrenal severa, insuficiencia suprarrenal aguda (trastorno), insuficiencia suprarrenal aguda, insuficiencia suprarrenal severa, Insuficiencia córticosuprarrenal aguda
Japanese アジソン病クリーゼ, 急性副腎皮質機能不全, 副腎クリーゼ, キュウセイフクジンヒシツキノウフゼン, アジソンビョウクリーゼ, フクジンクリーゼ, フクジンストーム, 副腎ストーム
Czech Addisonská krize, Adrenální krize, Adrenal storm (Akutní vyplavení hormonů kůry nadledvin), Akutní nedostatečnost kůry nadledvin
Korean 아디슨 발증
Hungarian Addison-crisis, Adrenalis crisis, Mellékvese izgalom, Acut mellékvesekéreg elégtelenség, Addisonos crisis

Ontology: Addison's disease due to autoimmunity (C0271737)

Concepts Disease or Syndrome (T047)
ICD10 E27.1
SnomedCT 76715008
English Adrenal atrophy (autoimmune), Addison disease due to autoimmunity, autoimmune adrenalitis, adrenalitis, autoimmune addison's disease, Addison's disease due to autoimmunity, Autoimmune adrenal atrophy, Autoimmune adrenalitis, Autoimmune Addison's disease, Addison's disease due to autoimmunity (disorder), autoimmune; adrenalitis, adrenalitis; autoimmune
Spanish atrofia adrenal autoinmune, atrofia suprarrenal autoinmunitaria, atrofia suprarrenal autoinmune, adrenalitis autoinmune, adrenalitis autoinmunitaria, enfermedad de Addison por autoinmunidad (trastorno), enfermedad de Addison por autoinmunidad
Dutch adrenalitis; auto-immuun, auto-immuun; adrenalitis

Ontology: Adrenal cortical hypofunction (C0405580)

Concepts Disease or Syndrome (T047)
ICD9 255.4
SnomedCT 267398003, 386584007, 154707007, 267483004, 68588005, 190527008
English ADRENAL CORTEX INSUFFIENCY, ADRENAL CORTEX HYPOFUNCTION, ADRENAL CORTICAL INSUFFICIENCY, INSUFFICIENCY ADRENAL CORTEX, Adrenal cortical hypofunction, NOS, Adrenocortical hypofunction, NOS, Corticoadrenal insufficiency, NOS, Hypoadrenocorticism, NOS, Corticoadrenal insuffic. NOS, Corticoadrenal insufficiency NOS, Adrenocortical insufficiency syndrome, Adrenal insufficiency NOS, Adrenal cortex hypofunction, Adrenal cortex insuffiency, Adrenal cortical insufficiency, Insufficiency adrenal cortex, Adrenal cortex insufficiency, corticoadrenal insufficiency (diagnosis), corticoadrenal insufficiency, adrenal cortical hypofunction, adrenal cortical insufficiency, Adrenal cortical hypofunction, Adrenal insufficiency, ADRENAL INSUFFICIENCY CORTICAL, Corticoadrenal insufficiency NOS (disorder), adrenal insufficiency, adrenal insufficiencies, adrenal cortex insufficiency, adrenocortical hypofunction, Adrenal Insufficiency, Adrenal cortical hypofunctions, Corticoadrenal insufficiency, Hypoadrenocorticism, Adrenal cortical hypofunction (disorder), Adrenocortical hypofunction, corticoadrenal; deficiency, corticoadrenal; hypofunction, deficiency; corticoadrenal, hypoadrenocorticism, hypofunction; adrenocortical, insufficiency; adrenal, adrenal cortex; deficiency, adrenal; insufficiency
Italian Ipofunzioni corticosurrenali, Ipocorticosurrenalismo, Insufficienza corticosurrenale, Insufficienza della corteccia surrenale, Ipofunzione corticosurrenale
Japanese 副腎皮質機能低下, フクジンヒシツキノウテイカ, 副腎皮質機能不全, フクジンヒシツキノウフゼン, 副腎皮質機能低下症, フクジンヒシツキノウテイカショウ
Spanish Corticoadrenal insufficiency, Corticoadrenal insufficiency NOS, Hipoadrenocorticismo, Hipofunción corticosuprarrenal, Insuficiencia de la corteza suprarrenal, Hipofunción cortical suprarrenal, Insuficiencia córticosuprarrenal, Insuficiencia corticoadrenal, CORTEZA SUPRARRENAL, HIPOFUNCION, CORTICOSUPRARRENAL, INSUFICIENCIA, hipoadrenocorticismo, hipofunción adrenocortical, hipofunción de corteza adrenal (trastorno), hipofunción de corteza adrenal, insuficiencia corticoadrenal, SAI (trastorno), insuficiencia corticoadrenal, SAI, insuficiencia corticoadrenal, insuficiencia corticosuprarrenal, insuficiencia suprarrenal (trastorno), insuficiencia suprarrenal, Hipofunción de la corteza suprarrenal
French Insuffisance corticosurrénale, Insuffisance cortico-surrénalienne, Hypofonction cortico-surrénale, Insuffisance corticale surrénalienne, Hypoadrénocorticisme, Insuffisance corticosurrénalienne, Hypofonction de la corticosurrénale, Insuffisance cortico-surrénale, HYPOFONCTIONN CORTICO-SURRENAL, INSUFFISANCE CORTICO-SURRENALE, Hypofonctions adréno-corticales
Dutch bijnierschorshypofunctie, hypoadrenocorticisme, insufficiëntie bijnierschors, bijnierschorsinsufficiëntie, bijnier; insufficiëntie, bijnierschors; deficiëntie, bijnierschors; hypofunctie, cortico-adrenaal; deficiëntie, deficiëntie; cortico-adrenaal, hypofunctie; bijnierschors, insufficiëntie; bijnier, bijnierschorshypofuncties
Portuguese Insuficiência córtico-supra-renal, Insuficiência cortical suprarrenal, Hipoadrenocorticismo, Hipofunção córtico-supra-renal, Insuficiência adrenocortical, HIPOFUNCAO DO CORTEX SUPRA-RENAL, INSUFICIENCIA CORTICO-SUPRA-RENAL, Hipofuncionamento cortical suprarenal
German Nebennierenrindenunterfunktion, Hypoadrenokortizismus, Insuffizienz der Nebennierenrinde, kortikoadrenale Insuffizienz, Nebennierenrindeninsuffizienz, NNR INSUFFIZIENZ, NNR UNTERFUNKTION, Unterfunktionen der Nebennierenrinde
Czech Hypofunkce nadledvinové kůry, Adrenokortikální nedostatečnost, Hypofunkce kůry nadledvin, Adrenokortikální hypofunkce, Nedostatečnost kůry nadledvin, Hypoadrenokorticismus, Insuficience kůry nadledvin, Insuficience adrenálního kortexu, Kortikoadrenální nedostatečnost
Hungarian adrenocorticalis elégtelenség, Mellékvesekéreg insufficientia, Mellékvesekéreg insufficiencia, Corticoadrenalis elégtelenség, Adrenocorticalis hypofunkciók, Mellékvese kéreg hypofunctio, Mellékvesekéreg hypofunctio, Mellékvesekéreg elégtelensége, adrenocorticalis hypofunctio