Carl R. Darnall Army Medical Center - Health Library

Adrenal Crisis

(Acute Adrenocortical Insufficiency)

Definition

The adrenal glands make a hormone called cortisol. It helps the body with blood pressure, metabolism, and the immune system. The body does not make enough of this hormone if you have adrenal crisis. Death may happen if you do not get care right away.

Adrenal Glands
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Pituitary Gland
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Causes  ^

Causes are:

  • Stopping corticosteroid medicine too quickly
  • Sepsis—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 (controls the adrenal gland)
  • Therapy to replace the thyroid hormone

Risk Factors  ^

Factors that may raise your chance of this are:

Symptoms  ^

You may have:

  • Weakness
  • Lightheadedness
  • Tiredness
  • Nausea and vomiting
  • Lack of hunger
  • Weight loss
  • Belly pain
  • High or low body temperature
  • Confusion
  • Diarrhea

Diagnosis  ^

You will be asked about your symptoms and health history. A physical exam will be done. If the doctor suspects an adrenal crisis, blood tests will be done.

Pictures may be taken. This can be done with MRI or CT scans.

Treatment  ^

Adrenal crisis is serious. It can result in death. You will need care right away.

Talk with your doctor about the best plan for you. You may need:

Fluids

Almost all people with adrenal crisis are low on body fluid. Large amount of fluids will be needed.

Medications

Medicines can help replace the missing hormones. This can ease health problems.

Prevention  ^

To lower your chance of an adrenal crisis:

  • If you take chronic oral corticosteroids, learn how to raise your dose if you become ill. Do not stop these medicines without talking to your doctor.
  • If you have adrenal gland problems and become ill, seek medical care right away.
  • If you have adrenal gland problems, make sure you have a steroid injection with you at all times. Ensure that you and those around you know how to give the injection.
  • If you have adrenal insufficiency, carry a medical ID card. Wear a bracelet that tells emergency workers about your problem.
RESOURCES:

American Association of Clinical Endocrinologists
http://www.aace.com

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Association of Emergency Physicians
http://www.caep.ca

Canadian Institute for Health Information
https://www.cihi.ca

REFERENCES:

Adrenal crisis causes death in some people treated with hGH. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/endocrine/national-hormone-pituitary-program/Pages/health-alert-hGH.aspx. Updated January 2018. Accessed August 17, 2018.

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/health-topics/endocrine/adrenal-insufficiency-addisons-disease/Pages/fact-sheet.aspx. Updated May 2014. Accessed August 17, 2018.

Adrenal insufficiency in adults. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116703/Adrenal-insufficiency-in-adults. Updated July 24, 2018. Accessed August 16, 2018.

Omori K, Nomura K, Shimizu S, Omori N, Takano K. Risk factors for adrenal crisis in patients with adrenal insufficiency. Endocrine J. 2003;50(6):745-752.

Thomas Z. An update on the diagnosis of adrenal insufficiency and the use of corticotherapy in critical illness. Ann Pharmacotherapy. 2007:41(9):1456-1465

Todd GRG, Acerini CL, Ross-Russell R, et al. Survey of adrenal crisis associated with inhaled corticosteroids in the United Kingdom. Arch. Dis Child. 2002;87(6):457-461.

Last reviewed June 2018 by EBSCO Medical Review BoardDaniel A. Ostrovsky, MD  Last Updated: 8/17/2018