Interní Med. 2014; 16(3): 119-122

Diagnosis and differential diagnosis of hypocorticism

prof.MUDr.Michal Kršek, CSc.

3. interní klinika &ndash, klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze

Hypocorticism is a state of insufficient secretion of adrenal cortex hormones mainly that of glucocorticoids and its clinical signs reflect

a disproportion between their secretion and demands. It is a serious state with nonspecific signs in mild forms; however, it can progress

to severe addisonian crisis with circulatory failure and a risk of death. Early establishment of correct diagnosis and immediate introduction

of replacement therapy are therefore essential. Assessment of morning serum cortisol levels is a basic examination to detect

hypocorticism regardless of aetiology. In partial deficiency and in case of uncertainty dynamic testing using insulin tolerance or ACTH

test is employed. For differential diagnosis between peripheral (primary) and central (secondary) causes measurement of morning ACTH

plasma levels is used and elevated levels indicate primary cause and decreased or normal levels indicate secondary cause. Present article

cover current view of diagnosis and differential diagnosis of hypocorticism.

Keywords: hypocorticism, cortisol, adrenals, pituitary, Addison

Published: May 26, 2014  Show citation