Acute Adrenal Crisis

Acute life-threatening adrenocortical insufficiency with markedly reduced serum cortisol, which arises in a background of chronic adrenocortical insufficiency (Addison’s disease).
Aetiology Infections, trauma, adrenal haemorrhage, tuberculosis, surgery, dehydration with salt deprivation, destruction of pituitary gland or evoked by replacing thyroid hormone in patients with hypothyroidism of hypothalamic or pituitary origin and underlying mild ACTH deficiency.
Triggers GI infection, fever
Clinical findings Hypotension, shock, fever, dehydration, anorexia, weakness, apathy, headache, vomiting, chills, tachycardia, sweating, abdominal pain
Lab Reduced Na+, increased K+, increased white cells, eosinophilia, hypoglycaemia
Management Pharmacologic doses of IV hydrocortisone, pressor support

acute adrenal crisis

Acute adrenal insufficiency Endocrinology A life-threatening condition caused by an abrupt ↓ cortisol At risk Pts Those taking corticosteroids for prolonged periods–wks to months–eg with Addison's disease, especially if steroids are stopped abruptly Clinical Shock, hypotension, weakness, headache, vomiting, fever, chills, tachycardia, sweating Management Vasopressors, steroids Prevention Taper steroid withdrawal

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References in periodicals archive

The key treatment during an acute adrenal crisis for these patients are intravenous hydrocortisone as well as normal saline with glucose solutions.

Adrenal hypoplasia congenita in identical twins

In patients with both TSH and ACTH deficiency or patients with autoimmune polyendocrine syndrome type II (primary hypothyroidism and Addison's disease), treatment with levothyroxine may precipitate an acute adrenal crisis because thyroxine increases cortisol metabolism [29, 30].

Havard, "Acute adrenal crisis precipitated by thyroxine," British Medical Journal (Clinical Research ed.), vol.

Pediatric Adrenal Insufficiency: Diagnosis, Management, and New Therapies

However, its diagnosis may be missed or delayed unless an illness or stress precipitates a severe cardiovascular collapse resulting in acute adrenal crisis. Early recognition of the clinical findings and treatment with glucocorticoids and rehydration with intravenous fluids, with or without mineralocorticoids and salt, are life-saving while attempts to confirm the diagnosis with extensive work-up are ongoing.

Latest Insights on the Etiology and Management of Primary Adrenal Insufficiency in Children

In the most severe form of the disorder, called salt-wasting CAH, or SWCAH, the body can't maintain a proper fluid balance, setting up a lifelong possibility of acute adrenal crisis characterized by dehydration, vomiting, diarrhea, low blood sugar, shock and even death.

September benefit targets rare disorder in infants

The patient presented with acute adrenal crisis and subsequently developed neurological disease.

Uncommon cause of acute adrenal failure/Akut surrenal yetersizliginin seyrek rastlanan bir nedeni

(3) A life-threatening pituitary insufficiency or an acute adrenal crisis may occur.

Acute pituitary apoplexy complicating a pituitary macroadenoma

These 14 articles describe endocrine diseases causing potentially life threatening emergencies, covering such topics as thyrotoxicosis, myxedema coma, acute adrenal crisis, acute calcium disorders, diseases of the sympathetic nervous system, hyperglycemic crises.

Acute endocrinology; from cause to consequence