Which of the following is a primary cause of adrenal insufficiency?

• A. Tuberculosis
• B. Diabetes
• C. Hypertension
• D. Asthma

Answer: (A)

Primary adrenal insufficiency happens when the adrenal cortex itself is destroyed, so the glands can’t produce enough cortisol (and often aldosterone). Tuberculosis can invade and destroy adrenal tissue, leading to impaired hormone production and Addison’s disease. This destruction of the adrenal cortex is what makes TB a primary cause.

The other options don’t directly injure the adrenal glands. Diabetes affects the pancreas, hypertension is a blood pressure problem, and asthma is an airway condition. While autoimmune destruction is a common cause in many settings, TB historically stands out as a classic infectious cause of primary adrenal insufficiency, especially in areas where TB is prevalent.