Idiopathic adrenal atrophy is the most common cause of adrenal insufficiency. It is not known exactly why this occurs, but it is believed to be related to an autoimmune response that results in the slow destruction of adrenal tissue. Tuberculosis, histoplasmosis, acquired immunodeficiency syndrome (AIDS), and hemorrhage into the adrenal glands have all been associated with destruction of the adrenal glands. All patients with adrenal insufficiency or steroid-dependent disorders are at risk for an acute adrenal crisis. Secondary adrenal failure can also occur with adrenocorticotropic hormone (ACTH) deficiency caused by disorders of the pituitary or hypothalamus or suppression because of glucocorticoid therapy.

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