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Adrenal Disorders

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Sex and Gender Differences in Pharmacology

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 214))

Abstract

The most frequent cause nowadays is autoimmune adrenalitis, which can be confirmed by the presence of 21-hydroxylase-antibodies (Oelkers 1996). When suspected on clinical grounds, adrenal insufficiency has to be confirmed by inappropriately low serum cortisol with elevated adrenocorticotropin (ACTH) (in case of primary adrenal insufficiency). A morning plasma cortisol ≤3 μg/dl is indicative for adrenal failure, whereas a cortisol ≥19 μg/dl rules out the disorder (Grinspoon and Biller 1994) if corticosterone-binding globulin (CBG) is normal. All other patients need dynamic testing (short ACTH stimulation test). A low ACTH in the presence of low cortisol points to secondary adrenal failure, in which case ACTH stimulation might be less reliable, especially when of recent onset.

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Abbreviations

11b-HSD2:

11β-hydroxysteroid-dehydrogenase

ACTH:

Adrenocorticotropin

BCRP1:

Breast cancer-resistance protein

BETA:

Betamethasone

CAH:

Congenital adrenal hyperplasia

CBG:

Corticosterone-binding globulin

DEX:

Dexamethasone

DHEA:

Dehydroepiandrosterone

GR:

Glucocorticoid receptor

MR:

Mineralocorticoid receptor

sGC:

Synthetic glucocorticoid

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Alois Gessl

  2. Department of Pharmacology and Toxicology, University of Vienna, Althanstrasse 14, 1090, Vienna, Austria

    Rosa Lemmens-Gruber

  3. Gender Medicine Unit, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Alexandra Kautzky-Willer

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  1. Alois Gessl
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  2. Rosa Lemmens-Gruber
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  3. Alexandra Kautzky-Willer
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Correspondence to Alexandra Kautzky-Willer .

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Editors and Affiliations

  1. Institute of Gender in Medicine (GiM), Center for Cardiovascular Research (CCR), Charité - Universitätsmedizin Berlin, Hessische Str. 3-4, Berlin, 10115, Germany

    Vera Regitz-Zagrosek

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Gessl, A., Lemmens-Gruber, R., Kautzky-Willer, A. (2013). Adrenal Disorders. In: Regitz-Zagrosek, V. (eds) Sex and Gender Differences in Pharmacology. Handbook of Experimental Pharmacology, vol 214. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30726-3_16

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