Adrenal crisis

Alternative names

Acute adrenal crisis; Addisonian crisis; Acute adrenal insufficiency

Definition

Acute adrenal crisis is a life-threatening state caused by insufficient levels of cortisol, which is a hormone produced and released by the adrenal gland.

Causes, incidence, and risk factors

The two adrenal glands are located on top of the kidneys. They consist of the outer portion, called the cortex, and the inner portion, called the medulla. The cortex produces three types of hormones, all of which are called corticosteroids.

Cortisol is a glucocortoid, a corticosteroid that maintains glucose regulation, suppresses the immune response, and is released as part of the body's response to stress. Cortisol production is regulated by a small gland just below the brain called the pituitary gland. Aldosterone is a type of corticosteroid known as a mineralocorticoid. It regulates the balance of sodium and potassium in the body. Both cortisol and aldosterone are essential for life.

Acute adrenal crisis is a medical emergency caused by a lack of cortisol. Patients may experience lightheadedness or dizziness, weakness, sweating, Abdominal pain, nausea and Vomiting, or even loss of consciousness.

Adrenal crisis occurs if the adrenal gland is deteriorating (Addison's disease, primary adrenal insufficiency), if there is pituitary gland injury (secondary adrenal insufficiency), or adrenal insufficiency is not adequately treated.

Risk factors for adrenal crisis include physical stress such as infection, trauma or surgery, adrenal gland or pituitary gland injury, and premature termination of treatment with steroids such as prednisone or hydrocortisone.

Symptoms

• headache
  
• profound weakness
  
• fatigue
  
• slow, sluggish, lethargic movement
  
• nausea
  
• Vomiting
  
• Low Blood pressure
  
• dehydration
  
• high fever
  
• shaking chills
  
• confusion or coma
  
• darkening of the skin (see Skin - abnormally dark or light)
  
• rapid heart rate