The most common problem involves 21 hydroxylase deficiency which may be of various severities. Aldosterone deficiency may accompany this. There may also be an over abundance of testosterone produced and this may cause an apparent precocious puberty in boys or psuedohemaphroditism in baby girl infants. Lesser degrees of this enzyme dysfunction can produce hirsutism in women during early adult life. Treatment of adrenal insufficiency involves taking replacement doses of a glucocorticoid.
Several preparations are available and include hydrocortisone, cortisone acetate, and prednisone.
Dosing must be individualized. Adrenal androgens are generally not replaced unless a patient has hypogonadism as well. In the event of trauma or major surgery, glucocorticoids must be given in larger doses to prevent shock.