Table 6.1-1. Causes of primary adrenal insufficiency


Adrenal hemorrhage, thrombosis, necrosis or infarction (due to coagulation disorder or sepsis)


– Autoimmune disorders: Autoimmune adrenalitis (most common)

– Infectious diseases: Tuberculosis, fungal infections, AIDS-related infections

– Medications: Cancer-related immunotherapies, ketoconazole, etomidate, tyrosine kinase inhibitors, antiepileptics

– Malignancy: Lymphoma, metastatic adrenal infiltrates (lung, breast, kidney)

– Genetic: Congenital adrenal hyperplasia, adrenoleukodystrophy (men), isolated

– Infiltrative: Amyloid, sarcoid, hemochromatosis