Adrenal Disorders

Investigating Primary Adrenal Insufficiency

Mrs. Johnson has a high serum ACTH so you are satisfied she has primary adrenal insufficiency.

How could you investigate for possible causes of Addison's?

Measure serum antibodies (anti 21-hydroxylase)

• Screen for other AI disease (thyroid disease, diabetes)

MRI adrenals

• May show atrophy, infarction, haemorrhage or tumour

Screen for rarer causes

• HIV, TB, secondary malignancy