Adrenal Crisis
Condition
(Acute Adrenocortical Insufficiency)
Definition
Adrenal crisis is a severe lack of a hormone called cortisol. It is made by the adrenal gland and helps the body with blood pressure, metabolism, and the immune system. Levels of another hormone called aldosterone may also be low.
This problem can be deadly.
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Causes
An adrenal crisis can be caused by:
- Stopping long term use of corticosteroid medicine too quickly
- Sepsis—a severe illness caused by an infection in the blood
- Stress from surgery
- Major sickness, such as a heart attack
- Harm to the adrenal glands or surgery to remove them
- Damage to the pituitary gland—it controls the adrenal gland
- Therapy to replace the thyroid hormone
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Risk Factors
Things that may raise the risk of adrenal crisis are:
- Septic shock
- Addison disease
- Taking steroids for a long time
- Tuberculosis or related diseases
- Having diseases of the immune system
- HIV
- Taking blood thinners
Symptoms
A person with adrenal crisis may have:
- Weakness or feel very tired
- Lightheadedness
- Nausea and vomiting
- Lost weight or is not hungry
- Belly pain
- High or low body temperature
- Confusion
- Diarrhea
Diagnosis
The doctor will ask about symptoms and health history. A physical exam will be done.
Blood and urine tests may be done to check hormone levels.
Pictures may be taken. This can be done with:
Treatment
This problem can be deadly. Care is needed right away. A person will need:
- Fluids to replace what the body has lost
- Medicines to replace missing hormones
Prevention
Managing Addison disease can lower the risk of this problem. People with Addison disease should talk to their doctor about what to do when they are sick or stressed. If they are sick or under stress they may need to:
- Take more medicine that replaces missing hormones
- Carry emergency medicine
American Association of Clinical Endocrinologists
National Institute of Diabetes and Digestive and Kidney Diseases
CANADIAN RESOURCES:
Canadian Association of Emergency Physicians
Canadian Institute for Health Information
American Association of Clinical Endocrinologists
National Institute of Diabetes and Digestive and Kidney Diseases
CANADIAN RESOURCES:
Canadian Association of Emergency Physicians
Canadian Institute for Health Information
References
- Adrenal insufficiency and Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease.
- Adrenal insufficiency in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/adrenal-insufficiency-in-adults.
- Nowotny, H., Ahmed, S.F., et al. Therapy options for adrenal insufficiency and recommendations for the management of adrenal crisis. Endocrine, 2021; 71 (3): 586-594.
Contributors
- James P. Cornell, MD
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