by EBSCO Medical Review Board
(Acute Adrenocortical Insufficiency)

Definition

Adrenal crisis is a severe lack of a hormone called cortisol. It is made by the adrenal gland and helps the body with blood pressure, metabolism, and the immune system. Levels of another hormone called aldosterone may also be low.

This problem can be deadly.

Adrenal Glands
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Causes

An adrenal crisis can be caused by:

  • Stopping long term use of corticosteroid medicine too quickly
  • Sepsis—a 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—it controls the adrenal gland
  • Therapy to replace the thyroid hormone
Pituitary Gland
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Risk Factors

Things that may raise the risk of this problem are:

Symptoms

A person with adrenal crisis may:

  • Feel weak
  • Be lightheaded
  • Be very tired
  • Have nausea and vomiting
  • Not be hungry or lose weight
  • Have belly pain
  • Have high or low body temperature
  • Be confused
  • Have diarrhea

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood and urine tests may be done to check hormone levels.

Pictures may be taken. This can be done with:

Treatment

This problem can be deadly. Care is needed right away. A person will need:

  • Fluids to replace what the body has lost
  • Medicines to replace missing hormones

Prevention

Managing Addison disease can lower the risk of this problem. People with Addison disease should talk to their doctor about what to do when they are sick or stressed. If they are sick or under stress they may need to:

  • Take more medicine that replaces missing hormones
  • Carry emergency medicine

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 insufficiency and Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease. Accessed April 29, 2022.

Adrenal insufficiency in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/adrenal-insufficiency-in-adults. Accessed April 29, 2022.

Nowotny, H., Ahmed, S.F., et al. Therapy options for adrenal insufficiency and recommendations for the management of adrenal crisis. Endocrine, 2021; 71 (3): 586-594.

Revision Information

  • Reviewer: EBSCO Medical Review Board James P. Cornell, MD
  • Review Date: 03/2022
  • Update Date: 04/29/2022