What are the clinical and laboratory differences in primary and secondary adrenal insufficency?
| Primary adrenal insufficiency | Secondary adrenal insufficiency |
| Clinical Differences | |
| Hyperpigmentation as ACTH levels high | no hyperpigmenation |
| Patient appears dehydrated | patient may appear edematous due to hypothyroidism |
| Decreased libido | Amenorrhea, scanty public and axillary hair, small testicles |
| Hypotension more profound | Hypotension |
| Hypoglycaemia | Hypoglycaemia more profound |
| Salt craving | No salt craving |
| No polyurea | Polyurea( diabetes insipidus) |
| Laboratory Differences | |
| ACTH high | ACTH low |
| Hyperkalemia | Potassium normal |
| Hyponatremia | Na decreased or normal |
| Renin increased | renin normal |
| Other pituitary hormone levels normal | other pituitary hormone levels decreased |
| Aldosterone decreased | Aldosterone normal |
Nicely summarized 👍