Table 6.1-1. Causes of central adrenal insufficiency

Acute

– Pituitary infarction/hemorrhage: Apoplexy, Sheehan syndrome

– Head trauma

– Pituitary/adrenal surgery

Chronic

– Medications: Long-term or high-dose exogenous glucocorticoid use, high-dose opioids, cancer immunotherapies

– Sellar masses: Pituitary adenomas, craniopharyngiomas, cystic lesions, metastases

– Infiltrative disease: Hemochromatosis, sarcoidosis, histiocytosis X

– Pituitary radiation

– Hypophysitis (autoimmune, granulomatous, IgG-4, xanthomatous)

– Posttraumatic state/surgery to the sellar region

– Empty sella syndrome