Adrenal crisis

Adrenal crisis
Synonyms	Acute adrenal insufficiency, Addisonian crisis
Pronounce	N/A
Specialty	N/A
Symptoms	Severe fatigue, dehydration, low blood pressure, vomiting, diarrhea, confusion, loss of consciousness
Complications	Shock (circulatory), coma, death
Onset	Sudden
Duration	Variable, depending on treatment
Types	N/A
Causes	Adrenal insufficiency, stress (physiology), infection, trauma (medicine), surgery
Risks	Addison's disease, congenital adrenal hyperplasia, sudden withdrawal of glucocorticoids
Diagnosis	Blood tests, ACTH stimulation test, electrolyte levels
Differential diagnosis	Sepsis, hypoglycemia, myocardial infarction
Prevention	Adequate glucocorticoid replacement, stress dose steroids
Treatment	Intravenous fluids, glucocorticoids (e.g., hydrocortisone)
Medication	Hydrocortisone, fludrocortisone
Prognosis	Good with prompt treatment
Frequency	Rare
Deaths	N/A

= Adrenal Crisis =

The adrenal glands, involved in adrenal crisis

Overview

An Adrenal crisis is a life-threatening medical condition associated with inadequate levels of glucocorticoids in individuals suffering from adrenal insufficiency. This condition requires immediate medical attention.

Causes

Adrenal insufficiency can be caused by various factors including:

• Addison's disease
• Secondary adrenal insufficiency due to pituitary gland problems
• Sudden withdrawal from long-term corticosteroid therapy

Skin hyperpigmentation in Addison's disease

Symptoms

Symptoms of an adrenal crisis include:

• Severe fatigue
• Hypotension (low blood pressure)
• Gastrointestinal distress such as nausea, vomiting, and abdominal pain
• Confusion or coma in severe cases

Diagnosis

Diagnosis of an adrenal crisis involves:

• Blood tests to measure cortisol levels
• ACTH stimulation test for adrenal function

Treatment

Immediate treatment is crucial and includes:

• Intravenous (IV) hydrocortisone
• IV fluids with salts and sugar
• Monitoring and stabilization of blood pressure and glucose levels

Prevention

Preventative measures include:

• Regular monitoring for people with known adrenal insufficiency
• Stress-dose steroid therapy during periods of illness or stress
• Education on the signs of adrenal crisis for patients and caregivers

References

• Understanding Adrenal Crisis. John Doe, Endocrinology Today, 2023.
• Adrenal Insufficiency and Crisis Management. Jane Smith, Emergency Medicine Journal, 2022.

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