;348:727-;361:1881-93楊純宜醫師IntroductionIncreasetissuecorticosteroidlevelsduringacuteillness-isanimportantprotectiveresponseManydiseasesandtreatmentsinterferewithnormalcorticosteroidresponsetoillnessandinducetissuecorticosteroidinsufficiencyReviewthephysiologyofcorticosteroidresponsetoacuteillnessDescribetheclinicalfeaturesofhypoadrenalismDiscusspracticalissuesrelatingtodiagnosisandtreatmentHistoryofadrenalinsufficiency1855ThomasAddison-clinicalsyndromecharacterisedbywastingandhyperpigmentationCauseasdestructionoftheadrenalgland1994life-savingglucocorticoid-replacementtherapydeveloped—Kendall,Sarett,andReichstein1stsynthesisedcortisoneEpidemiologyTwotypes—primary,secondaryChronicprimaryadrenalinsufficiency—prevalence93-140/million,--ageatdiagnosis4thdecade,womenmorefrequentlySecondaryadrenalinsufficiency—prevalence150-280/million-agepeaksin6thdecade,womenmorefrequentlyTherapeuticglucocorticoidadministration--moncause
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