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Table 2 Adrenal insufficiency, adrenal suppression (AS), and adrenal crisis: definitions and symptoms [20, 21]

From: Adrenal suppression: A practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy

Definition Signs/Symptoms
Adrenal insufficiency: Adrenal glands unable to produce a sufficient amount of cortisol secondary to ANY etiology (genetic, iatrogenic, acquired); may be associated with other adrenal hormone deficiencies. Weakness/fatigue
Malaise
Nausea
Vomiting
Diarrhea
Abdominal pain
Headache (usually in the morning)
Poor weight gain
Poor linear growth
Myalgia
Arthralgia
Psychiatric symptoms
Adrenal suppression (AS): Adrenal glands unable to produce a sufficient amount of cortisol secondary to exposure of the HPA axis to exogenous glucocorticoids, leading to suppression and, in turn, adrenal insufficiency. Weakness/fatigue
Malaise
Nausea
Vomiting
Diarrhea
Abdominal pain
Headache (usually in the morning)
Poor weight gain
Poor linear growth
Myalgia
Arthralgia
Psychiatric symptoms
Adrenal crisis: Severe, life-threatening adrenal insufficiency; can occur with AS. Hypotension
Hypoglycemia (seizure, coma)
  1. HPA: hypothalamic-pituitary-adrenal