Adrenal Crisis

Adrenal crisis is a life-threatening acute exacerbation of adrenocortical insufficiency, usually triggered by infection, surgery, trauma, sudden steroid withdrawal, or missed dose. Clinical: severe hypotension/shock, nausea/vomiting, abdominal pain, altered mental status/fever, dehydration, hyponatremia/hyperkalemia/hypoglycemia. It requires immediate treatment: IV isotonic saline, IV hydrocortisone 100 mg bolus then infusion, correct electrolytes/glucose; identify and treat precipitant.

Common Symptoms

Severe hypotension/shock; nausea/vomiting; abdominal pain; altered mental status; fever; dehydration; hyponatremia/hyperkalemia

Causes and Pathogenesis

Acute cortisol/aldosterone deficiency in a previously compromised adrenal axis, exacerbated by stress; loss of vascular tone and sodium/water depletion causes shock.

Treatment

Immediate IV isotonic saline; IV hydrocortisone 100 mg then 200 mg/24h; correct glucose/electrolytes; treat precipitating infection; pressors if refractory

Preventive Measures

Medical-alert bracelet; stress-dose sick-day rules; ensure steroid supply; patient education.

Department to Visit

It is recommended to visit the Emergency department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.