Hipokortisolisme

Hipokortisolisme, also known as adrenal insufficiency, is a condition where the adrenal glands do not produce enough of certain hormones, primarily cortisol and sometimes aldosterone. Cortisol is essential for regulating blood sugar, metabolism, and the body's response to stress, while aldosterone controls salt and water balance, which is vital for blood pressure.

The most common cause of hipokortisolisme is an autoimmune disorder where the body's immune system mistakenly attacks and destroys the adrenal cortex. Other causes can include infections like tuberculosis, certain medications, cancer, or bleeding into the adrenal glands. Primary adrenal insufficiency, also called Addison's disease, occurs when the adrenal glands themselves are damaged. Secondary adrenal insufficiency happens when the pituitary gland in the brain fails to produce enough adrenocorticotropic hormone (ACTH), which signals the adrenal glands to produce cortisol.

Symptoms of hipokortisolisme can develop gradually and may include chronic fatigue, muscle weakness, weight loss, and decreased appetite. Other signs can be low blood pressure, dizziness upon standing, nausea, vomiting, abdominal pain, and skin darkening. In severe cases, a sudden worsening of symptoms, known as an adrenal crisis, can occur, which is a life-threatening medical emergency characterized by severe pain in the back, abdomen, or legs, vomiting and diarrhea, low blood pressure, and loss of consciousness.

Diagnosis typically involves blood tests to measure hormone levels and stimulation tests to assess adrenal gland function. Treatment involves hormone replacement therapy, usually with corticosteroids like hydrocortisone, to replace the missing cortisol. In cases of aldosterone deficiency, mineralocorticoids like fludrocortisone may also be prescribed. Individuals with hipokortisolisme need to manage their condition carefully, especially during times of stress, illness, or injury, as they may require adjustments to their medication dosage.