Endocrine Disorders: Evaluation and Management

  • Author: Todd T. Brown, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 11/14/16 (What's New)

Summary

Introduction

  • Endocrine abnormalities are commonly observed among HIV-infected patients
  • Age-related endocrine problems, such as hypogonadism, have become more prevalent since the introduction of effective ART

Introduction to Adrenal Insufficiency

  • Adrenal insufficiency should be considered in patients with unexplained dizziness, fatigue, weight loss, hyperkalemia, or hyponatremia (Table 1)
  • Symptoms of adrenal insufficiency can also develop during stress, with withdrawal of steroids, or with intermittent steroid exposure and may be confused with HIV lipodystrophy[Samaras 2005]

Diagnosis of Adrenal Insufficiency

  • A serum cortisol sample drawn at 8:00 am (the period of peak cortisol secretion) is a useful screening test in most patients[Salvatori 2005]
  • A confirmed serum cortisol level < 3 µg/dL is diagnostic of adrenal insufficiency; levels > 18 µg/dL rule out the diagnosis[...

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