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MCID: SCN052
MIFTS: 35

Secondary Adrenal Insufficiency

Categories: Endocrine diseases, Rare diseases
Genes Tissues Related diseases Publications Pathways Drugs
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Aliases & Classifications for Secondary Adrenal Insufficiency

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MalaCards integrated aliases for Secondary Adrenal Insufficiency:

Name: Secondary Adrenal Insufficiency 20 70
Hypocortisolism Secondary to Another Disorder 70

Classifications:

MalaCards categories:
Global: Rare diseases
Anatomical: Endocrine diseases
See all MalaCards categories (disease lists)


External Ids:

UMLS 70 C0271738 C0948387
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Summaries for Secondary Adrenal Insufficiency

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GARD : 20 Adrenal insufficiency is an endocrine disorder that occurs when the adrenal glands do not produce enough of certain hormones. Secondary adrenal insufficiency occurs when the pituitary gland (a pea-sized gland at the base of the brain) fails to produce enough adrenocorticotropin (ACTH), a hormone that stimulates the adrenal glands to produce the hormone cortisol. The lack of these hormones in the body can be caused by reduction or cessation of corticosteroid medication, the surgical removal of pituitary tumors, or changes in the pituitary gland. Symptoms of secondary adrenal insufficiency may include severe fatigue, loss of appetite, weight loss, nausea, vomiting, diarrhea, muscle weakness, irritability, and depression. Treatment includes replacing the hormones that the adrenal glands are not making. The dose of each medication is adjusted to meet the needs of each affected individual.

MalaCards based summary : Secondary Adrenal Insufficiency, also known as hypocortisolism secondary to another disorder, is related to pituitary hormone deficiency, combined, 2 and diabetes insipidus. An important gene associated with Secondary Adrenal Insufficiency is PGM1 (Phosphoglucomutase 1), and among its related pathways/superpathways are Regulation of lipid metabolism Insulin signaling-generic cascades and HIF-1 signaling pathway. The drugs Epinephrine and Racepinephrine have been mentioned in the context of this disorder. Affiliated tissues include pituitary, kidney and liver.

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Related Diseases for Secondary Adrenal Insufficiency

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Diseases in the Rare Adrenal Disease family:

Secondary Adrenal Insufficiency Acute Adrenal Insufficiency
Acquired Chronic Primary Adrenal Insufficiency Chronic Primary Adrenal Insufficiency
Primary Adrenal Insufficiency

Diseases related to Secondary Adrenal Insufficiency via text searches within MalaCards or GeneCards Suite gene sharing:

(show top 50) (show all 181)
# Related Disease Score Top Affiliating Genes
1 pituitary hormone deficiency, combined, 2 30.4 IGF1 AVP
2 diabetes insipidus 30.3 INS AVP
3 hypopituitarism 30.1 INS IGFBP3 IGF1
4 sexual disorder 30.1 INS IGF1
5 hypothyroidism 29.9 INS IGFBP3 IGF1
6 hypoglycemia 29.8 INS IGFBP3 IGF1
7 hyperthyroidism 29.8 INS IGF1
8 pituitary apoplexy 29.7 INS IGF1 AVP
9 primary hyperparathyroidism 29.5 INS IGF1
10 sheehan syndrome 29.5 INS IGF1 AVP
11 empty sella syndrome 29.5 INS IGFBP3 IGF1
12 insulin-like growth factor i 29.2 INS IGFBP3 IGF1
13 turner syndrome 29.2 INS IGFBP3 IGF1
14 pituitary gland disease 29.0 INS IGFBP3 IGF1 AVP
15 primary adrenal insufficiency 10.3
16 hypogonadism 10.3
17 pituitary adenoma 10.3
18 growth hormone deficiency 10.3
19 acute adrenal insufficiency 10.3
20 pituitary tumors 10.2
21 atrial standstill 1 10.1
22 renal cell carcinoma, nonpapillary 10.1
23 conn's syndrome 10.1
24 adenoma 10.1
25 lymphocytic hypophysitis 10.1
26 traumatic brain injury 10.1
27 primary hypophysitis 10.1
28 benign essential hypertension 10.1 INS AVP
29 paralytic ileus 10.1 INS AVP
30 hypothalamic disease 10.1 INS AVP
31 lipoid congenital adrenal hyperplasia 10.1
32 thyrotropin-releasing hormone deficiency 10.1
33 pituitary adenoma, prolactin-secreting 10.1
34 alpha/beta t-cell lymphopenia with gamma/delta t-cell expansion, severe cytomegalovirus infection, and autoimmunity 10.1
35 premature ovarian failure 7 10.1
36 familial glucocorticoid deficiency 10.1
37 premature menopause 10.1
38 melanoma 10.1
39 autoimmune hepatitis 10.1
40 hepatitis 10.1
41 thyroiditis 10.1
42 broken heart syndrome 10.1
43 brain injury 10.1
44 spinal cord injury 10.1
45 wolfram syndrome 1 10.0 INS AVP
46 wolfram syndrome 10.0 INS AVP
47 mineral metabolism disease 10.0 INS AVP
48 hypothalamic obesity 10.0 INS IGF1
49 acidophil adenoma 10.0 INS IGF1
50 diabetic encephalopathy 10.0 INS IGF1

Graphical network of the top 20 diseases related to Secondary Adrenal Insufficiency:



Diseases related to Secondary Adrenal Insufficiency
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Symptoms & Phenotypes for Secondary Adrenal Insufficiency

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Drugs & Therapeutics for Secondary Adrenal Insufficiency

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Drugs for Secondary Adrenal Insufficiency (from DrugBank, HMDB, Dgidb, PharmGKB, IUPHAR, NovoSeek, BitterDB):

(show all 21)
# Name Status Phase Clinical Trials Cas Number PubChem Id
1
Epinephrine Approved, Vet_approved Phase 4 51-43-4 5816
2
Racepinephrine Approved Phase 4 329-65-7 838
3
Hydrocortisone Approved, Vet_approved Phase 4 50-23-7 5754
4
Hydrocortisone acetate Approved, Vet_approved Phase 4 50-03-3
5
Cortisone Experimental Phase 4 53-06-5 222786
6 Epinephryl borate Phase 4
7 Anti-Inflammatory Agents Phase 4
8 Hydrocortisone 17-butyrate 21-propionate Phase 4
9 Hydrocortisone hemisuccinate Phase 4
10 Hormones Phase 4
11 Hormone Antagonists Phase 4
12 Hydrocortisone-17-butyrate Phase 4
13 glucocorticoids Phase 4
14
Progesterone Approved, Vet_approved 57-83-0 5994
15
Cosyntropin Approved 16960-16-0 16129617
16
Triamcinolone Approved, Vet_approved 124-94-7 31307
17 11-hydroxyprogesterone
18 17 alpha-Hydroxyprogesterone Caproate
19 Triamcinolone hexacetonide
20 Triamcinolone diacetate
21 triamcinolone acetonide

Interventional clinical trials:


# Name Status NCT ID Phase Drugs
1 A Randomized Double Blind Cross-over Study of the Effects of Low Dose and High Dose Hydrocortisone Replacement Therapy on Cognition, Quality of Life, Metabolic Profile and Somatosensation in Patients With Secondary Adrenal Insufficiency Completed NCT01546922 Phase 4 Hydrocortisone
2 A Randomized, Controlled, Multi-Centre Trial on the Effects of Dual-release Hydrocortisone Preparations Versus Conventional Glucocorticoid Replacement Therapy in Patients Affected by Primary and Secondary Adrenal Insufficiency. DREAM Trial. Completed NCT02277587 Phase 4 Plenadren;Conventional glucocorticoid therapy
3 Mass Spectrometry Based Cutoffs for Cortisol and 17-hydroxy-progesterone (17-OH-progesterone) After Stimulation Tests for Primary and Secondary Adrenal Insufficiency. Unknown status NCT02818660 Synachten
4 Low Dose (1mcg ) ACTH Stimulation Test for Assessment of the Hypothalamo- Pituitary- Adrenal Axis in Patients Treated With Intravitreal Injection of Triamcinolone Acetonide Completed NCT00561236
5 The Prevalence of Secondary Adrenal Insufficiency in Patients With Exacerbation of COPD in Glucocorticoid Treatment Related to Differenct Gene Polymorphisms of the Glucocorticoid Receptor Gene Completed NCT03140761

Search NIH Clinical Center for Secondary Adrenal Insufficiency

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Genetic Tests for Secondary Adrenal Insufficiency

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Anatomical Context for Secondary Adrenal Insufficiency

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MalaCards organs/tissues related to Secondary Adrenal Insufficiency:

40
Pituitary, Kidney, Liver, Lung, Spinal Cord, Adrenal Gland, Bone
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Publications for Secondary Adrenal Insufficiency

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Articles related to Secondary Adrenal Insufficiency:

(show top 50) (show all 509)
# Title Authors PMID Year
1
The relationship between early post-operative ACTH / cortisol following pituitary surgery and long-term glucocorticoid requirement - Do ultradian rhythms matter? 61
33369760 2021
2
Isolated ACTH deficiency induced by cancer immunotherapy: a systematic review. 61
33761049 2021
3
Oral Contraceptive Disturbed the Recovery of the Adrenal Function after Adrenalectomy in Cushing Syndrome. 61
33055479 2021
4
Real-world treatment and health care resource use among severe asthma patients in Japan. 61
33789828 2021
5
Therapy options for adrenal insufficiency and recommendations for the management of adrenal crisis. 61
33661460 2021
6
Investigation of the Hypothalamo-pituitary-adrenal (HPA) axis: a contemporary synthesis. 61
33770352 2021
7
Increased mortality risk in patients with primary and secondary adrenal insufficiency. 61
33596308 2021
8
Cardiovascular disease in patients with primary and secondary adrenal insufficiency and the role of comorbidities. 61
33585930 2021
9
Adrenal insufficiency updates in children. 61
33278125 2021
10
Long-term corticosteroid use, adrenal insufficiency and the need for steroid-sparing treatment in adult severe asthma. 61
33598993 2021
11
Multiple endocrinopathies, hypercalcaemia and pancreatitis following combined immune checkpoint inhibitor use- case report and review of literature. 61
33639911 2021
12
Adrenal insufficiency. 61
33484633 2021
13
Clinical features and thyroid dysfunction in adverse events involving the pituitary gland during PD-1 blockade therapy. 61
33037658 2021
14
Acute illness in children with secondary adrenal insufficiency. 61
33544418 2021
15
[Endocrine late-effects and bone mineral density after combined treatment of malignant brain tumors in childhood and adolescence]. 61
33586390 2021
16
Adrenal Insufficiency Caused by Chronic Corticosteroid Use, Identified through Medication Therapy Management. 61
33384031 2021
17
Takotsubo cardiomyopathy associated with adrenal insufficiency in the context of long-term steroid use mimicking acute coronary syndrome. 61
33495195 2021
18
Preliminary results from whole-genome expression analysis in patients with secondary adrenal insufficiency treated with modified-release hydrocortisone. 61
33417142 2021
19
Consideration regarding immune checkpoint inhibitor-induced secondary adrenal insufficiency in patients lacking human leucocyte antigen-DR15. 61
33279853 2021
20
Adrenal insufficiency in kidney transplant patients during low-dose prednisolone therapy: a cross-sectional case-control study. 61
31539081 2020
21
The Eyes Cannot See What the Mind Does Not Know: Endocrinological Side Effects of Ibrutinib. 61
33428844 2020
22
Masked Diabetes Insipidus Hidden by Severe Hyponatremia: A Case of Pituitary Metastasis of Lung Adenocarcinoma. 61
33335085 2020
23
Perioperative Evaluation and Management of Endocrine Disorders. 61
33168157 2020
24
[Comparative study of glucagon and insulin tests for diagnostics of secondary adrenal insufficiency and growth hormone deficiency in children and adolescents]. 61
33481367 2020
25
Metabolic Effects of Cortisone Acetate vs Hydrocortisone in Patients With Secondary Adrenal Insufficiency. 61
33241171 2020
26
Health-related quality of life in patients with non-functioning pituitary adenoma: a special focus on hydrocortisone replacement dose. 61
32737686 2020
27
Masked type 1 diabetes mellitus (T1DM) unveiled by glucocorticoid replacement: a case of simultaneous development of T1DM and hypophysitis in an elderly woman. 61
32669510 2020
28
Salivary cortisol levels during Ramadan fasting in hydrocortisone-treated secondary adrenal insufficiency patients. 61
32789535 2020
29
Comparing the utility of 30- and 60-minute cortisol levels after the standard short synacthen test to determine adrenal insufficiency: A retrospective cross-sectional study. 61
33120750 2020
30
The role of glucocorticoid supplementation in children with secondary adrenal insufficiency undergoing anaesthesia for imaging examinations. 61
32578203 2020
31
Treatment with Intravenous Methylprednisolone in Patients with Graves' Orbitopathy Significantly Affects Adrenal Function: Assessment of Serum, Salivary Cortisol and Serum Dehydroepiandrosterone Sulfate. 61
33050327 2020
32
Pembrolizumab Induced Hypophysitis in a Patient Allergic to Triamcinolone: An Increasingly Recognized Endocrinopathy Related to Immunotherapy. 61
33116112 2020
33
Hypogonadism: Is It Always Hypogonadotropic in an Adolescent With a Cleft Palate? A Surprising Case of Klinefelter Syndrome. 61
33107323 2020
34
IATROGENIC CUSHING SYNDROME IN AN HIV-INFECTED PATIENT SECONDARY TO CONCOMITANT THERAPY WITH GENVOYA AND EPIDURAL TRIAMCINOLONE. 61
32984524 2020
35
Pituitary Macroadenoma Presenting as Acromegaly and Subacute Pituitary Apoplexy: Case Report and Literature Review. 61
32923214 2020
36
Adrenal function following ACTH therapy for infantile spasms: A retrospective study. 61
32544771 2020
37
Isolated Adrenocorticotropic Hormone Deficiency Secondary to Chronic Opiate Use. 61
32821615 2020
38
Acute Unilateral Oculomotor Nerve Palsy as the Initial Presenting Sign of Nonfunctioning Apoplectic Gonadotroph Adenoma. 61
32742834 2020
39
Checkpoint Inhibitor in a Melanoma Patient With Polyendocrinopathy and Gangrenous Gallbladder With a Mass. 61
32724737 2020
40
Second day morning cortisol levels after transsphenoidal surgery are accurate predictors of secondary adrenal insufficiency with diagnostic cut-offs similar to non-stressed conditions. 61
32492678 2020
41
Adrenal insufficiency: Physiology, clinical presentation and diagnostic challenges. 61
32035851 2020
42
Secondary adrenal insufficiency: an insidious consequence of the opioid epidemic? 61
32430440 2020
43
Guidelines for the management of glucocorticoids during the peri-operative period for patients with adrenal insufficiency: Guidelines from the Association of Anaesthetists, the Royal College of Physicians and the Society for Endocrinology UK. 61
32017012 2020
44
Human leucocyte antigen DR15, a possible predictive marker for immune checkpoint inhibitor-induced secondary adrenal insufficiency. 61
32229416 2020
45
Nivolumab Induced Adrenal Insufficiency: Rare Side-effect of a New Anti-cancer Therapy - Immune-checkpoint Inhibitors. 61
32399358 2020
46
Hypopituitarism manifesting after invasive dental treatment in a patient with carcinoma of the tongue: a case report. 61
32293413 2020
47
Cut-off values for sufficient cortisol response to low dose Short Synacthen Test after surgery for non-functioning pituitary adenoma. 61
31907611 2020
48
Long-acting porcine sequence ACTH in the diagnosis of adrenal insufficiency: a cost-effective alternative to the ACTH1-24 test. 61
31770103 2020
49
Nivolumab-induced Adrenal Insufficiency in Patients With Renal Cell Carcinoma. 61
31567704 2020
50
Symptomatic Pituitary Metastasis as Initial Manifestation of Renal Cell Carcinoma: Case Report and Review of Literature. 61
32908722 2020
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Variations for Secondary Adrenal Insufficiency

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Expression for Secondary Adrenal Insufficiency

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Search GEO for disease gene expression data for Secondary Adrenal Insufficiency.
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Pathways for Secondary Adrenal Insufficiency

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Pathways related to Secondary Adrenal Insufficiency according to GeneCards Suite gene sharing:

# Super pathways Score Top Affiliating Genes
1
Regulation of lipid metabolism Insulin signaling-generic cascades 23
Show member pathways
 12.34 INS IGFBP3 IGF1
2
HIF-1 signaling pathway 36
11.49 INS IGF1
3
Senescence and Autophagy in Cancer 1
11.16 INS IGFBP3 IGF1
4
Cardiac Progenitor Differentiation 1
11.13 INS IGF1
5
Ovarian steroidogenesis 36
11.08 INS IGF1
6
Differentiation Pathway 1
11 INS IGF1
7
Aldosterone-regulated sodium reabsorption 36
10.82 INS IGF1
8
Mesenchymal Stem Cell Differentiation Pathways and Lineage-specific Markers 64
10.78 INS IGFBP3 IGF1
9
Regulation of Insulin-like Growth Factor (IGF) transport and uptake by Insulin-like Growth Factor Binding Proteins (IGFBPs) 65
10.48 IGFBP3 IGF1
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GO Terms for Secondary Adrenal Insufficiency

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Cellular components related to Secondary Adrenal Insufficiency according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 extracellular space GO:0005615 9.56 INS IGFBP3 IGF1 AVP
2 extracellular region GO:0005576 9.55 PGM1 INS IGFBP3 IGF1 AVP
3 insulin-like growth factor ternary complex GO:0042567 8.96 IGFBP3 IGF1
4 insulin-like growth factor binding protein complex GO:0016942 8.62 IGFBP3 IGF1

Biological processes related to Secondary Adrenal Insufficiency according to GeneCards Suite gene sharing:

(show all 16)
# Name GO ID Score Top Affiliating Genes
1 positive regulation of cell proliferation GO:0008284 9.7 INS IGF1 AVP
2 positive regulation of gene expression GO:0010628 9.69 INS IGF1 AVP
3 wound healing GO:0042060 9.56 INS IGF1
4 positive regulation of phosphatidylinositol 3-kinase signaling GO:0014068 9.55 INS IGF1
5 positive regulation of cell growth GO:0030307 9.54 INS AVP
6 cellular protein metabolic process GO:0044267 9.5 INS IGFBP3 IGF1
7 glucose metabolic process GO:0006006 9.49 PGM1 INS
8 positive regulation of glucose import GO:0046326 9.48 INS IGF1
9 activation of protein kinase B activity GO:0032148 9.46 INS IGF1
10 ERK1 and ERK2 cascade GO:0070371 9.43 IGF1 AVP
11 positive regulation of mitotic nuclear division GO:0045840 9.4 INS IGF1
12 positive regulation of glycolytic process GO:0045821 9.37 INS IGF1
13 negative regulation of release of cytochrome c from mitochondria GO:0090201 9.26 IGF1 AVP
14 positive regulation of glycogen biosynthetic process GO:0045725 9.16 INS IGF1
15 positive regulation of insulin-like growth factor receptor signaling pathway GO:0043568 8.96 IGFBP3 IGF1
16 positive regulation of MAPK cascade GO:0043410 8.8 INS IGFBP3 IGF1

Molecular functions related to Secondary Adrenal Insufficiency according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 insulin receptor binding GO:0005158 9.16 INS IGF1
2 insulin-like growth factor receptor binding GO:0005159 8.96 INS IGF1
3 hormone activity GO:0005179 8.8 INS IGF1 AVP
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Sources for Secondary Adrenal Insufficiency

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3 CDC
7 CNVD
9 Cosmic
10 dbSNP
11 DGIdb
17 EFO
18 ExPASy
19 FMA
20 GARD
28 GO
29 GTR
30 HMDB
31 HPO
32 ICD10
33 ICD10 via Orphanet
34 ICD9CM
35 IUPHAR
36 KEGG
37 LifeMap
39 LOVD
41 MedGen
44 MeSH
45 MESH via Orphanet
46 MGI
49 NCI
50 NCIt
51 NDF-RT
53 NINDS
54 Novoseek
56 OMIM via Orphanet
57 OMIM® (Updated 20-May-2021)
61 PubMed
63 QIAGEN
68 SNOMED-CT via HPO
69 Tocris
70 UMLS
71 UMLS via Orphanet
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