Adrenal insufficiency - Revision history

Aidan: /* Differential Diagnosis */

2021-03-06T16:01:16Z

Differential Diagnosis

← Older revision		Revision as of 16:01, 6 March 2021
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	*Infectious		*Infectious
	**[[Tuberculosis]]		**[[Tuberculosis]]
	**[[Neisseria meningitidis\|Meningococcemia]] causing [[~~Waterhouse–Friderichsen~~ syndrome]]		**[[Neisseria meningitidis\|Meningococcemia]] causing [[Waterhouse-Friderichsen syndrome]]
	**[[HIV medications\|HIV]], [[CMV in pregnancy\|CMV]]		**[[HIV medications\|HIV]], [[CMV in pregnancy\|CMV]]
	**[[Histoplasmosis]]		**[[Histoplasmosis]]

Aidan at 15:58, 6 March 2021

2021-03-06T15:58:39Z

← Older revision		Revision as of 15:58, 6 March 2021
Line 7:		Line 7:
	*Infectious		*Infectious
	**[[Tuberculosis]]		**[[Tuberculosis]]
	**[[Neisseria meningitidis\|Meningococcemia]] causing [[~~Waterhouse-Friedrickson~~ syndrome]]		**[[Neisseria meningitidis\|Meningococcemia]] causing [[Waterhouse–Friderichsen syndrome]]
	**[[HIV medications\|HIV]], [[CMV in pregnancy\|CMV]]		**[[HIV medications\|HIV]], [[CMV in pregnancy\|CMV]]
	**[[Histoplasmosis]]		**[[Histoplasmosis]]

Aidan: /* Differential Diagnosis */

2021-03-03T01:39:38Z

Differential Diagnosis

← Older revision		Revision as of 01:39, 3 March 2021
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	*Inflammatory/Autoimmune		*Inflammatory/Autoimmune
	**Primary autoimmune		**[[Primary adrenal insufficiency\|Primary (autoimmune) adrenal insufficiency]]
	**[[Sarcoidosis]]		**[[Sarcoidosis]]
	**[[Antiphospholipid syndrome]]		**[[Antiphospholipid syndrome]]

Aidan at 01:38, 3 March 2021

2021-03-03T01:38:28Z

← Older revision		Revision as of 01:38, 3 March 2021
Line 1:		Line 1:
	== Differential Diagnosis ==		==Differential Diagnosis==

	* Inflammatory/Autoimmune		*Inflammatory/Autoimmune
	** Primary autoimmune		**Primary autoimmune
	** Sarcoidosis		**[[Sarcoidosis]]
	** Antiphospholipid syndrome		**[[Antiphospholipid syndrome]]
	* Infectious		*Infectious
	** Tuberculosis		**[[Tuberculosis]]
	** Meningococcemia causing Waterhouse-Friedrickson		**[[Neisseria meningitidis\|Meningococcemia]] causing [[Waterhouse-Friedrickson syndrome]]
	** HIV, CMV		**[[HIV medications\|HIV]], [[CMV in pregnancy\|CMV]]
	** Histoplasmosis		**[[Histoplasmosis]]
	* Malignancy		*Malignancy
	** Metastases, especially breast cancer		**[[Metastases]], especially [[breast cancer]]
	* Other		*Other
	** Systemic anticoagulation		**Systemic [[anticoagulation]]
	** Adrenoleukodystrophy		**[[Adrenoleukodystrophy]]

	== Management ==		==Management==

	* Treat with dexamethasone while awaiting result of ACTH stimulation test to confirm diagnosis		*Treat with [[dexamethasone]] while awaiting result of ACTH stimulation test to confirm diagnosis
	** At 1h after ACTH, cortisol should be above 550 and have increased by 250		**At 1h after ACTH, cortisol should be above 550 and have increased by 250
	* Stress dosing, to be given for 24h unless ongoing illness		*Stress dosing, to be given for 24h unless ongoing illness
	** Hydrocortisone 300mg (divided q8h)		**[[Hydrocortisone]] 300mg (divided q8h)
	** Prednisone 60mg		**[[Prednisone]] 60mg
	** Methylprednisolone 50mg		**[[Methylprednisolone]] 50mg
	** Dexamethasone 8mg		**[[Dexamethasone]] 8mg
	* After stress dosing, can deescalate quickly to physiologic doses		*After stress dosing, can deescalate quickly to physiologic doses
	** Prednisone 7.5mg daily or 5mg/2.5mg split, with fludrocortisone 0.1mg daily		**[[Prednisone]] 7.5mg daily or 5mg/2.5mg split, with fludrocortisone 0.1mg daily
	** Hydrocortisone 20mg/10mg split, without fludrocortisone		**[[Hydrocortisone]] 20mg/10mg split, without fludrocortisone
	* For future stress dosing during intercurrent illnesses, can simply double dose when febrile		*For future stress dosing during intercurrent illnesses, can simply double dose when febrile

	[[Category:Endocrinology]]		[[Category:Endocrinology]]

Maintenance script: Imported from text file

2020-07-04T01:17:22Z

Imported from text file

New page

== Differential Diagnosis ==

* Inflammatory/Autoimmune
** Primary autoimmune
** Sarcoidosis
** Antiphospholipid syndrome
* Infectious
** Tuberculosis
** Meningococcemia causing Waterhouse-Friedrickson
** HIV, CMV
** Histoplasmosis
* Malignancy
** Metastases, especially breast cancer
* Other
** Systemic anticoagulation
** Adrenoleukodystrophy

== Management ==

* Treat with dexamethasone while awaiting result of ACTH stimulation test to confirm diagnosis
** At 1h after ACTH, cortisol should be above 550 and have increased by 250
* Stress dosing, to be given for 24h unless ongoing illness
** Hydrocortisone 300mg (divided q8h)
** Prednisone 60mg
** Methylprednisolone 50mg
** Dexamethasone 8mg
* After stress dosing, can deescalate quickly to physiologic doses
** Prednisone 7.5mg daily or 5mg/2.5mg split, with fludrocortisone 0.1mg daily
** Hydrocortisone 20mg/10mg split, without fludrocortisone
* For future stress dosing during intercurrent illnesses, can simply double dose when febrile

[[Category:Endocrinology]]