GENERAL HISTOLOGY

Detailed explanation-1: -Secondary adrenal insufficiency occurs when the pituitary gland doesn’t make enough of the hormone ACTH. The adrenal glands then don’t make enough cortisol. Mild symptoms may be seen only when a person is under physical stress. Other symptoms may include weakness, fatigue, and weight loss.

Detailed explanation-2: -Secondary adrenal insufficiency is most commonly caused by medications, such as prednisone, intra-articular injections with steroids, or steroid creams. In this situation, the adrenal glands may take days to months to recover function and restore proper cortisol production.

Detailed explanation-3: -Chronic use of corticosteroids inhibits the function of the hypothalamic-pituitary-adrenal axis by negative feedback, which may cause adrenal insufficiency also after the cessation of corticosteroid treatment (4, 6). Adrenal insufficiency is a serious, potentially life-threatening side effect of corticosteroid use.

Detailed explanation-4: -Patients for whom reduction and /or cessation of corticosteroid is planned, may be at risk of adrenal insufficiency if the duration of corticosteroid use was prolonged beyond 4 weeks, with increasing risk for longer exposure, such as 6-12+months.