| {"diagnostic": {"Suspected Adrenal Insufficiency": {"Primary Adrenal Insufficiency": [], "Secondary Adrenal Insufficiency": [], "Congenital Adrenal Hyperplasia": []}}, "knowledge": {"Suspected Adrenal Insufficiency": {"Risk Factors": "Autoimmune diseases; Genetic predisposition; Infections (e.g., tuberculosis, HIV); Adrenal hemorrhage; Anticoagulant therapy; Chronic use of glucocorticoids or other immunosuppressive drugs; Certain medications that affect adrenal function; etc.", "Symptoms": "Fatigue; Muscle weakness; Weight loss; Gastrointestinal symptoms (nausea, vomiting, diarrhea); Low blood sugar; Hyperpigmentation (in primary adrenal insufficiency); Various abnormal manifestations of skin;Changes in serum potassium levels; Salt craving; Dizziness or fainting upon standing; Low blood sugar levels; etc.", "Signs": "Hyperpigmentation (especially in creases of skin, on scars, or gums, in primary adrenal insufficiency); Low blood pressure; especially when standing (orthostatic hypotension); Dehydration; Abdominal tenderness; Electrolyte imbalances (hyponatremia, hyperkalemia); Rapid heart rate; etc."}, "Primary Adrenal Insufficiency": "1. Often there are high ACTH levels because the adrenal glands do not respond to ACTH \n 2. Both PAI and SAI may present with hyporesponsiveness, but in PAI cortisol does not increase even when ACTH is given because the adrenal glands are damaged \n 3. In PAI, imaging studies may show structural abnormalities in the adrenal glands.\n 4. May be associated with significant electrolyte imbalances such as hyponatremia and hyperkalemia \n 5. Aldosterone is usually not involved, so hyperkalemia is unlikely \n 6 have Addison's disease. \n", "Secondary Adrenal Insufficiency": "1. ACTH levels are low or normal because the problem originates from the pituitary gland or hypothalamus, which does not secrete ACTH adequately.\n 2. Cortisol increases when ACTH is given \n 3 For SAI, an MRI or CT scan may be needed to evaluate the structure of the pituitary gland and hypothalamus .\n", "Congenital Adrenal Hyperplasia": "1.Hormone measurements in blood and urine, specifically 17 hydroxyprogesterone (17-OHP), cortisol, androgens, and aldosterone. 2.Patients with CAH often present with abnormally elevated 17-OHP levels. 3.ACTH stimulation test: Measures changes in 17-OHP levels before and after ACTH (adrenocorticotropic hormone) injection to evaluate adrenocortical function.4. Genetic testing can confirm the diagnosis of CAH and identify the specific type of enzyme defect, the most common being 21-hydroxylase deficiency.\n"}} |