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Potentially life-threatening emergency
Adrenal crisis
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Potentially life-threatening emergency

Adrenal crisis

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Contributors: Benjamin L. Mazer MD, MBA, Marilyn Augustine MD
Other Resources UpToDate PubMed

Synopsis

Potentially life-threatening condition of mineralocorticoid deficiency in the presence of chronic adrenal insufficiency. Commonly caused by gastrointestinal infection, fever, acute stress, and adrenal and pituitary disorders. Characterized by shock and hypotension, it may present with sudden pain in abdomen, back or legs, nausea, vomiting, delirium, Addison disease, hyperkalemia, and hyponatremia. Other symptoms may include anorexia, weakness, lethargy, hypoglycemia, and coma.

Urgent treatment is required for adrenal crisis, beginning with isotonic saline or dextrose in isotonic saline infusion in order to normalize electrolytes. Then, dexamethasone or hydrocortisone and, after stabilization, countering the cortisol deficiency with glucocorticoid replacement therapy. Infectious causes should be treated with antibiotics as needed.

Codes

ICD10CM:
E27.2 – Addisonian crisis

SNOMEDCT:
24867002 – Severe adrenal insufficiency

Differential Diagnosis & Pitfalls

Best Tests

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 08/12/2016
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Potentially life-threatening emergency
Adrenal crisis
Print 1 Images
Adrenal crisis : Abdominal pain, Fever, Nausea, Vomiting, Delirium, Hyperkalemia, Hypoglycemia, Na decreased
Copyright © 2019 VisualDx®. All rights reserved.