ABSTRACT
Primary Adrenal Failure Primary adrenal failure is manifested clinically by glucocorticoid and mineralocorticoid deficiency. It may result from autoimmune adrenalitis (Addison disease), the most common cause in the United States; destruction of the adrenals by a granulomatous process such as tuberculosis; bilateral adrenal hemorrhage related to sepsis, anticoagulation therapy or a lupus anticoagulant; congenital adrenal enzyme deficiency; or the use of drugs, such as aminoglutethimide or ketoconazole, that inhibit steroidogenesis. Adrenal metastases are common in metastatic malignancies such as lung cancer, but clinically pronounced adrenocortical failure is uncommon.
