![]() Despite many advances in recent years, there is currently no curative option, and modern cortisol replacement regimens fail to adequately mimic physiological cortisol rhythm. As primary AI is a relatively rare condition, most medical specialists will only manage a handful of these patients in their career. Currently, there remains a wide variation in the management of this condition across Europe. Sudden withdrawal from chronic glucocorticoid therapy is the most common cause of AI. The diagnosis, easily confirmed by demonstrating inappropriately low cortisol secretion, is often delayed by months, and many patients present with acute adrenal crisis. However, discovery of cortisone in the 1940s not only improved the life expectancy of these patients but also had a dramatic effect on their overall quality of life. ![]() ![]() This was an invariably fatal condition in Addison’s days with most patients dying within a few years of diagnosis. Adrenal insufficiency (AI), first described by Thomas Addison in 1855, is characterised by inadequate hormonal production by the adrenal gland, which could either be primary, due to destruction of the adrenal cortex, or secondary/tertiary, due to lack of adrenocorticotropic hormone or its stimulation by corticotropin-releasing hormone.
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