Adrenal Crisis

What is adrenal crisis?

Adrenal crisis is a life-threatening emergency caused by inadequate cortisol during severe physiological stress.

It can occur in people with known adrenal insufficiency or in some people with previously unrecognized adrenal insufficiency.

What can trigger adrenal crisis?

Possible triggers include:

• Severe infection
• Vomiting or diarrhoea
• Major injury
• Surgery
• Severe illness
• Sudden interruption of steroid replacement
• Inadequate steroid dose during significant physical stress

What are the symptoms?

Warning signs can include:

• Severe weakness
• Vomiting
• Diarrhoea
• Abdominal pain
• Dehydration
• Low blood pressure
• Dizziness or fainting
• Confusion
• Low sodium
• Low blood glucose in some patients

Untreated adrenal crisis can be fatal.

What should I do if I suspect adrenal crisis?

This is an emergency.

A person with suspected adrenal crisis needs immediate medical treatment, including parenteral glucocorticoid therapy and appropriate fluid resuscitation. Treatment should not be delayed while waiting for confirmatory test results in a severely ill patient.

What if I have adrenal insufficiency and develop vomiting?

Vomiting may prevent absorption of oral steroid medication and can increase the risk of adrenal crisis.

Urgent medical assessment and emergency steroid treatment may be required.

Should people with adrenal insufficiency carry emergency medication?

Yes. Patients with adrenal insufficiency should be educated about emergency steroid treatment and should have appropriate medical-alert identification and an emergency glucocorticoid plan.

Can stopping steroids suddenly cause adrenal problems?

Yes. Prolonged glucocorticoid treatment can suppress the body's own cortisol production, and abrupt withdrawal can cause adrenal insufficiency in susceptible individuals.

Should I stop my steroid medicine when I feel better?

Do not stop long-term steroid treatment abruptly without medical advice.