[Adrenal insufficiency]

Although adrenal insufficiency is considered a rare condition, recent epidemiological studies indicate a rising incidence of the disease. It may result from the presence of either primary adrenal disorder (Addison's disease) or of pituitary pathology. Addison's disease can present as an isolated entity or in combination with other autoimmune diseases. The clinical manifestations of this syndrome are caused by the deficiency of glucocorticoids and mineralocorticoids, which is often accompanied by adrenal androgen depletion. Patients usually experience skin hyperpigmentation, asthenia, weight loss, salt craving, abnormal defecation dynamics, as well as abdominal pains. In some persons adrenal insufficiency may, however, manifest as a life-threatening crisis. Because the onset of symptoms is gradual while its manifestation is sometimes non-specific, the correct diagnosis may be easily missed. At the present time, there is no absolute agreement among endocrinologists about the optimal management of this condition. In this review article, we discuss the causes, clinical picture, diagnosis and treatment of adrenal insufficiency and provide the reader with some practical guidance concerning dealing with a patient suffering from this disorder.