Adrenal insufficiency in women

Chronic adrenocortical hypofunction, also known as Addison's disease, is caused by damage to bilateral adrenaline due to autoimmune diseases, serious infections such as tuberculosis, or tumors, or by partial or complete removal of both sides. It can also be secondary to insufficient production of CRH by the hypothalamus-pituitary gland and ACTH by the pituitary gland.

Chronic adrenal insufficiency

This article will mainly discuss the producers of adrenaline itself. Clinically, this disease presents symptoms such as weakness, weight loss, pigmentation, and low blood pressure. Most of the patients are middle-aged, elderly and young people, most of whom are between 20 and 50 years old. The incidence rate is basically the same between men and women, and those with unclear causes are mostly women.

Chronic adrenal insufficiency (I) Primary

It is a disease of the adrenal glands themselves, and the causes of the disease can be divided into:

Chronic adrenal insufficiency Chronic adrenal gland damage

Vaguely caused contracture of blood pressure, also known as refractory contracture, is mostly caused by immune diseases. Refractory adrenal insufficiency is often accompanied by sexual dysfunction, hyperfunction of thyroid cysts, hypofunction of thyroid cysts, Hashimoto's thyroiditis, diabetes, vitiligo, pernicious anemia and hypothyroidism. 40% to 50% of refractory Addison's disease is accompanied by one or more of the various autoimmune system diseases. Antigens related to the above-mentioned disease were found in the blood circulation of many cases. About 60% of the patients had adrenaline antigens, 45% had anti-thyroid antibodies (2:1 for females and males), 30% had anti-gastric mucosal cell antigens, 26% had thyroid antigens, and 8% had pancreatic islet cell antigens. About 80% of the diseases are caused by autoimmunity. Some people have found that 21-hydroxylase is a key autoantigen in refractory Addison's disease. Blood infections, such as tuberculosis, syphilis, bacteria (Histoplasma, Candida species, Gram-negative bacilli, yeast, Coccidioides, etc.). In the past, tuberculosis was the key cause of Addison's disease in China. Many patients had tuberculosis lesions in their bodies, and there were calcification shadows in the adrenaline area, which might be caused by old tuberculosis. However, tuberculosis has been increasingly controlled, so the cause of this disease is mostly due to immune diseases. After receiving effective fungal treatment, patients with Addison's disease caused by fungi may recover their adrenaline function; replenish cell infiltration, and be damaged due to various metastatic tumors and sepsis. Probably because adrenaline has abundant blood vessels and high concentrations of adrenal corticosteroids, cancer patients are often accompanied by adrenaline infiltration and metastasis. When about 1/5 of the adrenal glands remain intact, the metabolism of aldosterone will be affected. If the damage to the adrenal glands continues to expand, the metabolism of aldosterone will decrease; weight-bearing degeneration, such as amyloidosis; full-term vascular diseases, such as vasculitis, adrenal vein thrombosis with obstruction, bilateral cortical exudative lesions, etc.; those caused by subtotal or complete removal of both sides of the tube.

Chronic adrenal insufficiency Deficiency of corticosteroid anabolic enzymes

Blood pressure Congenital deficiency of 21-hydroxylase, 11-hydroxylase or 17-hydroxylase; Addison-Schilder disease (coexistence of idiopathic leukodystrophy and adrenal insufficiency); congenital adrenal insufficiency, which is an autosomal recessive inheritance, in which adrenaline does not respond accordingly to ACTH stimulation (accompanied by hypoglycemia and pigmentation), blood ACTH is increased, aldosterone is decreased, and blood aldosterone and urinary 17-hydroxysteroid hormones are decreased. Blood-derived disease can be caused by drugs or chemicals that inhibit enzymes, such as metyrapone inhibiting 11-β-hydroxylase, O, P′DDD dissolving cortical cell tissue, etc., but it has no important practical significance in the occurrence of this disease.

Chronic adrenal insufficiency (II) Secondary

It is secondary to insufficient hypothalamic-pituitary metabolism of CRH and pituitary metabolism of ACTH.

Chronic adrenal insufficiency Blood pressure Endogenous

It includes hypothalamic pituitary diseases, which are caused by various tumors, inflammation, cell infiltration, trauma, vascular diseases, etc.; and pituitary diseases caused by postpartum hemorrhage and puerperal fever, tumors, and sequelae of meningitis and encephalitis.

Chronic adrenal insufficiency Blood exogenous

Because long-term and large-dose use of glycogenocorticosteroids inhibits hypothalamic pituitary function, hypofunction symptoms occur after drug withdrawal; intrathecal injection of hydroxyprednisolone (hydroxyprednisolone methylprednisolone) for more than 3 months, the pituitary gland is affected by the high concentration of steroid hormones, resulting in symptoms and clinical signs of adrenal insufficiency and inability to respond to exogenous ACTH.