Adrenal insufficiency: from concept to treatment
Keywords:Health education; Adrenal insufficiency; Diagnosis.
Adrenal Insufficiency (AI) is a clinical condition resulting from the deficient synthesis of the hormone cortisol by the cortex of the glands located just above the kidneys. Cortisol performs several essential functions in the body, interfering with metabolism, blood pressure and inflammatory processes. AI can be classified as primary or secondary. The primary form occurs early on in the adrenal gland itself. Glandular inflammation, inherited enzyme deficits and infectious processes are the most common causes. The secondary form in this situation, the initial problem is in the hypothalamus or the pituitary gland, located at the base of the brain. Tumors in this portion or abrupt discontinuation of glucocorticoid therapy are the most frequently seen. The following article aimed to describe from concept to treatment of adrenal insufficiency. This is a narrative review of literature based on SciELO, MEDLINE, BVS, SBEM platforms, in the time frame of the last 5 years. There is a lot of information on the subject in the scientific literature. Possibly this underscores the importance of the topic, in which current data on the definition, classification, clinical picture, diagnosis and treatment of AI are made available in full. In view of the information collected, it can be clarified that AI is a syndrome with clinical implications that urge an early and differential diagnosis, investigation of the etiological cause and appropriate treatment according to the clinical condition of the patient and the form of presentation of AI.
Alexandraki, K.I. & Grossman A. (2019). Management of Hypopituitarism. J Clin Med., 8(12), 2153. doi:10.3390/jcm8122153
Alexandraki, K. I., & Kaltsas, G. A. (2022). Adrenal insufficiency and pregnancy. Current Opinion in Endocrinology, Diabetes, and Obesity, 29(3), 277–283. https://doi.org/10.1097/MED.0000000000000726
Alves, C., Robazzi, T. C. V. & Mendonça, M. (2008). Retirada da corticoterapia: recomendações para a prática clínica. Jornal de Pediatria, 84(3), 192-202. https://doi.org/10.2223/JPED.1773.
Bennett, G., Cussen, L., & O’Reilly, M. W. (2022). The role for long-term use of dehydroepiandrosterone in adrenal insufficiency. Current Opinion in Endocrinology, Diabetes, and Obesity, 29(3), 284–293. https://doi.org/10.1097/MED.0000000000000728
Bowden S.A., Connolly A. M., Kinnett K. & Zeitler P.S. (2019). Management of Adrenal Insufficiency Risk After Long-term Systemic Glucocorticoid Therapy in Duchenne Muscular Dystrophy: Clinical Practice Recommendations. J Neuromuscul Dis, 6(1), 31-41. doi:10.3233/JND-180346.
Caetano, J. D. S., Castilho, S. R. de, & Santos, V. dos. (2021). Perspective of pharmaceutical practice in adrenal insufficiency: An integrative review. Research, Society and Development, 10(7), e5610716197. https://doi.org/10.33448/rsd-v10i7.16197
Esslami, G. G., & Moienafshar, A. (2022). Neonatal bilateral adrenal hemorrhage and adrenal insufficiency accompanied by Subgaleal hematoma: a case report with brief review of literature. BMC Pediatrics, 22(1), 248. https://doi.org/10.1186/s12887-022-03314-1
Gupta, P., Sharma, R., & Jain, V. (2022). Adrenal hypoplasia congenita-hypogonadotropic hypogonadism syndrome due to NR0B1 gene mutations. Indian Journal of Pediatrics, 89(6), 587–590. https://doi.org/10.1007/s12098-021-04055-2
Grossman, A. B. ([s.d.]). Insuficiência adrenal secundária. Manuais MSD edição para profissionais. https://www.msdmanuals.com/pt-br/profissional/dist%C3%BArbios-end%C3%B3crinos-e-metab%C3%B3licos/dist%C3%BArbios-adrenais/insufici%C3%AAncia-adrenal-secund%C3%A1ria
Huecker, M.R., Bhutta, B.S., Dominique, E. & Bossuah, K. A. (2021). Insuficiência adrenal (nursing). Treasure Island (FL): StatPearls Publishing. Retrieved from https://fs53slaq3neykuquxervhfvj5a-adv7ofecxzh2qqi-www-ncbi-nlm-nih-gov.translate.goog/books/NBK568707/
Mendes, A. L. V., Gaspar, W. S., Madeira, I. R., Bordallo, A. P. N., Gilban, D. S., Borschiver, C. et al. (2017). Insuficiência adrenal primária causada por deleção no gene DAX1. Residência em Pediatria, 7(3):114-7. DOI: https://doi.org/10.25060/residpediatr-2017.v7n3-07 e
Menzies-Gow, A., Kreindler, J., Katial, R., & Gurnell, M. (2022). Adrenal insufficiency in patients taking benralizumab as corticosteroid sparing therapy - Authors’ reply. The Lancet. Respiratory Medicine, 10(1), e8. https://doi.org/10.1016/S2213-2600(21)00489-6
Morais, L. R. de, Abreu, C. A., Silva, G. G. L. da, Campos, I. C. de O., Maia, L. M. G., Silva, L. R., Berardo, M. M. de C., Silva, M. S., Oliveira, R. E. S., & Aquino, M. L. A. (2020). A importância da triagem neonatal como diagnóstico precoce da hiperplasia adrenal congênita. Brazilian Journal of Health Review, 3(4), 10814–10825. https://doi.org/10.34119/bjhrv3n4-339
Nieman, L. K. (2021). Patient education: Adrenal insufficiency (Addison's disease) (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/adrenal-insufficiency-addisons-disease-beyond-the-basics
Oprea, A., Bonnet, N., Pollé, O., & Lysy, P. A. (2019). Novel insights into glucocorticoid replacement therapy for pediatric and adult adrenal insufficiency. Therapeutic advances in endocrinology and metabolism, 10. https://doi.org/10.1177/2042018818821294
Shah, K., Boyd, J. W., Broussard, J. R., Ginn, K., Rahmetulla, R., Hurst, K., & Goyal, R. K. (2022). Adrenocortical function in children with brain tumors and pediatric hematopoietic cell transplantation recipients. Journal of Pediatric Hematology/Oncology, 44(2), e469–e473. https://doi.org/10.1097/MPH.0000000000002220
Singhal, M., Sharma, S., Tom, N. B., Agarwal, M. K., & Mathur, A. (2022). A study of adrenal insufficiency in hemodynamically stable patients with cirrhosis. The Journal of the Association of Physicians of India, 70(4), 11–12. https://pesquisa.bvsalud.org/portal/resource/pt/mdl-35443330
Vieira, D. S. (2021, September 19). Diagnóstico e tratamento da insuficiência adrenal. Dra. Suzana Vieira. https://drasuzanavieira.med.br/2021/09/19/diagnostico-e-tratamento-da-insuficiencia-adrenal/
How to Cite
Copyright (c) 2022 Lanna do Carmo Carvalho; Marivaldo de Moraes e Silva ; Oxana Gaião dos Reis ; Nathália Gomes da Silva ; Debora Oliveira Queiroz Machado; Vicente Dias de Oliveira Junior; Laís da Costa Silva ; Andresa Mayra de Sousa Melo ; Sofia Carneiro Mansur Silva; Camila Melo Diogo Soler; Edivaldo Bezerra Mendes Filho
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.