Epidemiology and etiology

Adrenal insufficiency generally refers to the inability of the adrenal glands to produce adequate amounts of cortisol for normal physiologic functioning or in times of stress. The condition is usually classified as primary, secondary, or tertiary, depending on the etiology (Table 45-1)2,4-8 The estimated prevalences of primary adrenal insufficiency and secondary adrenal insufficiency are approximately 60 to 143 and 150 to 280 cases per one million persons, respectively. Primary adrenal insufficiency is usually diagnosed in the third to fifth decade of life, whereas secondary adrenal insufficiency is commonly detected during the sixth decade.2,9 Adrenal insufficiency is more prevalent in women than in men, with a ratio of 2.6:12 Chronic adrenal insufficiency is rare.

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