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Saturday, May 31, 2008

Hypothalmic-pituitary-adrenal (HPA) axis suppression

This is the most common cause of adrenal insufficiency 
Long-term use of gluccocorticoids can cause this, and it is characterized by:
low CRH
low ACTH
low cortisol

The patient will have a low BP due to the low cortisol

In a healthy individual CRH stimulates ACTH which in turn stimulates Cortisol.

Normally Cortisol provides negative feedback for CRH and ACTH so when a patient has ectopic secretion of cortisol you will see decreased CRH and ACTH


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