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CPE-008 · Classification
AI-08: Work-up of the cause in primary pattern
Work-up of the cause in primary pattern. Evaluates primary pattern (AI-06).
Active rulePriority 4Adrenal engine v1.0.0
Condition
- primary pattern (AI-06)
What it reports
- Autoimmune adrenalitis is the most common cause: check 21-hydroxylase antibodies
- If negative, consider imaging and tuberculosis, hemorrhage, metastases, infection and adrenoleukodystrophy (young men)
Diagnostic boundary
- Prompts, not conclusions.
Evidence
- EV-ES-PAI-2016Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(2):364-389.Supports: Morning cortisol and ACTH as first tests; ACTH stimulation with 250 µg cosyntropin; peak cortisol below 18 µg/dL as insufficient Suspected adrenal crisis must be treated without waiting for tests
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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