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Acute adrenal crisis

Contents of this page:

Illustrations

Endocrine glands
Endocrine glands
Adrenal gland hormone secretion
Adrenal gland hormone secretion

Alternative Names    Return to top

Adrenal crisis; Addisonian crisis; Acute adrenal insufficiency

Definition    Return to top

Acute adrenal crisis is a life-threatening condition that occurs when there is not enough cortisol, a hormone produced by the adrenal glands.

Causes    Return to top

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 glucocorticoid -- a corticosteroid that:

Cortisol production is regulated by a small gland just below the brain called the pituitary gland. Cortisol is essential for life.

Adrenal crisis occurs when:

Risk factors for adrenal crisis include:

Symptoms    Return to top

Exams and Tests    Return to top

Treatment    Return to top

In adrenal crisis, patients need an immediate injection of hydrocortisone through a vein (intravenous) or muscle (intramuscular). You may receive intravenous fluids if you have low blood pressure.

You will need to go to the hospital for treatment and monitoring. If infection caused the crisis, you may need antibiotic therapy.

Outlook (Prognosis)    Return to top

Shock may occur if treatment is not provided early, and it can be life-threatening.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if you have Addison's disease and are unable to keep your medications down because of vomiting.

Go to the emergency room or call the local emergency number (such as 911) if you develop symptoms of acute adrenal crisis.

Prevention    Return to top

If you have Addison's disease, you should learn to recognize signs of potential stress that may cause an acute adrenal crisis. Most people with Addison's disease are taught to give themselves an emergency injection of hydrocortisone or increase their dose of oral prednisone in times of stress.

It is important to always carry a medical identification card that states the type of medication and the proper dose you need in case of an emergency.

Never miss your medications.

References    Return to top

Stewart PM. The adrenal cortex. In: Kronenberg H, Melmed S, Polonsky K, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 14.

Update Date: 3/18/2008

Updated by: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed byDavid Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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