Acute adrenal insufficiency

Acute adrenal insufficiency is a rare, potentially life-threatening condition that occurs when the adrenal glands, located above the kidneys, cannot produce enough of the hormone cortisol. Cortisol helps the body respond to stress, maintain blood pressure and cardiovascular function, and slow the immune system's inflammatory response.

Causes

Acute adrenal insufficiency can be caused by a variety of factors. The most common cause is the abrupt discontinuation of long-term, high-dose glucocorticoid therapy. Other causes include severe physical stress such as surgery, trauma, or infection; adrenal hemorrhage; and certain medications, such as ketoconazole, etomidate, and metyrapone.

Symptoms

Symptoms of acute adrenal insufficiency can vary but often include severe fatigue, loss of appetite, weight loss, nausea, vomiting, abdominal pain, muscle weakness, dizziness, and low blood pressure. If not treated promptly, it can lead to shock, coma, and death.

Diagnosis

Diagnosis of acute adrenal insufficiency typically involves blood tests to measure cortisol and adrenocorticotropic hormone (ACTH) levels. An ACTH stimulation test may also be performed. Imaging tests, such as a CT scan or MRI, may be used to check for abnormalities in the adrenal glands.

Treatment

Treatment for acute adrenal insufficiency involves replacing the deficient hormones. This is typically done with medications such as hydrocortisone, prednisone, or dexamethasone. In cases of adrenal crisis, immediate medical attention is required, and treatment typically involves intravenous administration of hydrocortisone, fluids, and electrolytes.

See also

• Addison's disease
• Adrenal gland
• Adrenal insufficiency
• Cortisol
• Adrenocorticotropic hormone