Clinical Profile of Adrenal Insufficiency: A Study in a Tertiary Care Centre

Adrenal insufficiency (AI) is an uncommon but potentially fatal endocrine disorder caused by inadequate secretion of adrenal hormones. Because the presenting symptoms are often vague, diagnosis may be delayed, especially in developing countries. This study aimed to analyze the clinical characteristics, etiological factors, and laboratory findings of patients diagnosed with adrenal insufficiency at a tertiary care center. A retrospective review of 22 confirmed cases was conducted over a period of two years. Diagnosis was established based on early morning serum cortisol levels below 3 mcg/dL or levels between 3-15 mcg/dL with an inadequate response to the cosyntropin stimulation test. The gender distribution was equal among the study participants. Primary adrenal insufficiency accounted for approximately 41% of cases and was observed predominantly among female patients. Autoimmune disease represented the most common cause of primary adrenal insufficiency, whereas tuberculosis contributed significantly to both primary and secondary adrenal insufficiency. The most frequent presenting manifestations included fatigue, dizziness, vomiting, and postural hypotension. Early identification through clinical suspicion and electrolyte screening may improve outcomes and prevent adrenal crisis.