Relative adrenal insufficiency

Donald L. Loriaux, Maria Fleseriu

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations


PURPOSE OF REVIEW: This article will review the clinical presentation, diagnosis, and treatment of acute adrenal insufficiency and explore the concept of 'relative adrenal insufficiency' in the critically ill. RECENT FINDINGS: Current dogma suggests that as many as 70% of patients in intensive care units with the clinical syndromes of sepsis or cardiogenic shock have 'relative adrenal insufficiency'. This article will explore how this concept came into being and why the concept has no clinical utility. SUMMARY: This article will provide an approach to critically ill patients that will identify adrenal insufficiency when it is part of the pathophysiology of a given patient and, at the same time, prevent the unnecessary treatment of critically ill patients with high doses of glucocorticoids for 'stress' when adrenal insufficiency is not a factor in the illness.

Original languageEnglish (US)
Pages (from-to)392-400
Number of pages9
JournalCurrent Opinion in Endocrinology, Diabetes and Obesity
Issue number5
StatePublished - Oct 2009


  • Cortrosyn stimulation test
  • Plasma-free cortisol
  • Relative adrenal insufficiency

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics


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