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Alternative Names Return to topAdrenal 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.