TABLE 2

Clinical manifestations of adrenal insufficiency by organ system^a

General
Fatigue, generalized weakness
Muscle weakness
Muscle and joint pain
Loss of appetite
Weight loss
Fever^b

Gastrointestinal
Nausea and vomiting
Abdominal pain
Acute abdomen with tenderness and rigidity^b
Constipation or diarrhea
Salt craving^c

Dermatologic
Hyperpigmentation of skin, mucous membranes, hair, and nails^c
Vitiligo^c
Dry, itchy skin
Auricular cartilage calcification (males)

Cardiovascular
Shock^b
Intravascular volume depletion
Hypotension/orthostatic hypotension
Tachycardia/orthostatic tachycardia
Tachypnea

Neuropsychiatric
Dizziness, postural dizziness
Depression^d
Memory impairment^d
Psychosis (rare)^d
Confusion^b
Decreased level of consciousness^b

Reproductive (women):
Decreased axillary and pubic hair
Decreased libido
Amenorrhea

Endocrine
Autoimmune endocrine disorders,^c eg, hypothyroidism
Other pituitary hormonal abnormalities^e

↵a Clinical manifestations depend on rate of onset and severity of adrenal insufficiency.
↵b Only in adrenal crisis.
↵c Only in primary adrenal insufficiency.
↵d Only in long-standing adrenal insufficiency.
↵e Only in secondary or tertiary adrenal insufficiency.