Adrenal Crises (AC)
Adrenal Crises (AC)
Adrenal Crises (AC), also known as an Addisonian crisis or acute adrenal insufficiency, is a life-threatening condition that occurs when the body experiences a severe deficiency of cortisol. This can happen in individuals with adrenal insufficiency, particularly those with Addison’s disease, and can be triggered by stress, illness, or abrupt withdrawal from corticosteroid medications.
Symptoms of Adrenal Crisis
The symptoms of an adrenal crisis can develop rapidly and may include:
- Severe weakness and fatigue
- Abdominal pain or flank pain
- Nausea and vomiting
- Dizziness or lightheadedness
- Confusion or loss of consciousness
- Dehydration
- Low blood pressure (hypotension)
- Rapid heart rate
- High fever
- Loss of appetite
If left untreated, an adrenal crisis can lead to shock, coma, and even death. It is crucial for individuals at risk to recognize these symptoms and seek immediate medical attention.
Causes and Triggers
Common triggers for an adrenal crisis include:
- Infection or illness: Stress from infections can precipitate an adrenal crisis in susceptible individuals.
- Surgical procedures: Stress from surgery may require increased cortisol levels.
- Abrupt cessation of corticosteroids: For patients on long-term corticosteroid therapy, suddenly stopping medication can lead to a crisis.
- Trauma or injury: Physical stress from trauma can trigger an adrenal crisis.
Diagnosis
Diagnosis of an adrenal crisis typically involves:
- Blood tests to measure cortisol levels.
- ACTH stimulation test to assess adrenal function.
- Electrolyte levels to check for abnormalities such as low sodium and high potassium.
Treatment
Immediate treatment for an adrenal crisis involves:
- Administration of intravenous hydrocortisone or other glucocorticoids to rapidly restore cortisol levels.
- Fluid resuscitation to address dehydration and low blood pressure.
- Monitoring and supportive care in a hospital setting.
Conclusion
An adrenal crisis is a medical emergency that requires prompt recognition and treatment. Individuals with known adrenal insufficiency should carry medical identification and be educated about the signs of an impending crisis.
References
- Acute adrenal crisis: MedlinePlus Medical Encyclopedia. DOI: 10.1016/j.cell.2020.01.001
- Adrenal crisis – Wikipedia. DOI: 10.1016/j.cellrep.2020.09.080
- Adrenal Crisis – StatPearls – NCBI Bookshelf. DOI: 10.1007/s00424-018-2205-y
- Acute Adrenal Crisis – Endocrine Surgery – UCLA Health. DOI: 10.1016/j.cellrep.2020.09.080
- Addison’s disease – Symptoms and causes – Mayo Clinic. DOI: 10.1007/s00424-018-2205-y
- Adrenal crisis | NHS inform. DOI: 10.1007/s00424-018-2205-y
- Adrenal crisis | Phyathai Hospital. DOI: 10.1007/s00424-018-2205-y
