Central adrenal insufficiency: who, when, and how? From the evidence to the controversies - an exploratory review.

Arch Endocrinol Metab

Unidade de Endocrinologia do Desenvolvimento, Disciplina de Endocrinologia, Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade São Paulo, São Paulo, SP, Brasil,

Published: September 2022

AI Article Synopsis

  • * Diagnosing CAI is difficult due to its subtle symptoms and the complexities involved in laboratory testing.
  • * This review seeks to summarize existing literature on identifying, diagnosing, and treating CAI effectively, highlighting when and who should investigate this disorder.

Article Abstract

Central adrenal insufficiency (CAI) is a life-threatening disorder. This occurs when ACTH production is insufficient, leading to low cortisol levels. Since corticosteroids are crucial to many metabolic responses under organic stress and inflammatory conditions, CAI recognition and prompt treatment are vital. However, the diagnosis of CAI is challenging. This is not only because its clinical presentation is usually oligosymptomatic, but also because the CAI laboratory investigation presents many pitfalls. Thus, the clarification of when to use each test could be helpful in many contexts. The CAI challenge is also involved in treatment: Several formulations of synthetic steroids exist, followed by the lack of a biomarker for glucocorticoid replacement. This review aims to access all available literature to synthesize important topics about who should investigate CAI, when it should be suspected, and how CAI must be treated.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697652PMC
http://dx.doi.org/10.20945/2359-3997000000493DOI Listing

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