Common causes of primary adrenal insufficiency
Autoimmune Isolated Autoimmune polyglandular syndrome type 1 Autoimmune polyglandular syndrome type 2 |
Adrenal infection Tuberculosis Human immunodeficiency virus Cytomegalovirus Fungal infections: candidiasis, histoplasmosis, paracoccidioidomycosis Syphilis African trypanosomiasis |
Adrenal metastases Breast, lung, colon, stomach cancers or lymphoma |
Adrenal hemorrhage Trauma Anticoagulation Antiphospholipid syndrome |
Congenital adrenal hyperplasia 21-hydroxylase deficiency 11-hydroxylase deficiency 3B-hydroxysteroid dehydrogenase II deficiency |
Drug-induced primary adrenal insufficiency Adrenal enzyme inhibitors: mitotane, ketoconazole, metyrapone, etomidate Drugs that accelerate cortisol metabolism: fluconazole, phenytoin, rifampin, barbiturates Immune checkpoint inhibitors Anti-PD-1 (programmed cell death protein 1) monoclonal antibodies: pembrolizumab, nivolumab CTLA-4 (cytotoxic T-lymphocyte antigen 4) inhibitor: ipilimumab |
Others Adrenoleukodystrophy and adrenomyeloneuropathy Familial glucocorticoid deficiency Familial glucocorticoid resistance |