[Primary and secondary adrenal insufficiency in adults]

Adrenal insufficiency is defined by a loss of synthesis and secretion of mineralo and/or glucocorticoid hormones. Various are the responsible mechanisms. They can directly affect the adrenal glands or induce a functional drop in steroid hormone secretion through the deficiency of ACTH production. The pattern of appearance of an adrenal insufficiency can be slowly progressive or, in contrast, occur as an acute event. In all case, the adrenal insufficiency can lead to an adrenal crisis that is a life-threatening complication. After performing the diagnosis of adrenal insufficiency, the occurrence of an adrenal crisis should be prevented by a vigilant care. The treatment of adrenal insufficiency is based on a hormonal replacement by mineralo and/or glucocorticoids. It will be completed, when possible, by an etiological therapy. That justifies to identify precisely the implicated cause after the diagnosis of adrenal insufficiency was performed. Indeed, associated with the steroid substitution, a specific etiological therapy is indicated in some cases of either primary or secondary adrenal insufficiency.