Secondary adrenal insufficiency is characterized by low cortisol and low to normal ACTH caused by decreased ACTH secretion from the pituitary. Īn Addisonian crisis most often occurs in a patient with known adrenal insufficiency, either primary or secondary. Primary adrenal insufficiency (Addison Disease) is characterized by low cortisol and high ACTH from the destruction of the adrenal glands. Chronic, stable primary adrenal insufficiency is called Addison disease, a chronic condition controlled with long-term glucocorticoid therapy. Īddisonian crisis refers to an episode of acute adrenal insufficiency (which may be primary, secondary, or tertiary), which is a medical emergency. The mainstay of treatment is early recognition of the underlying adrenal insufficiency and resolution of symptoms after administering IV fluids and parenteral glucocorticoid administration. It is characterized as an acute change in physiologic status, quickly progression from nonspecific symptoms of fatigue, weakness, nausea, vomiting, abdominal pain, back pain, diarrhea, dizziness, hypotension, syncope, eventually to obtundation, metabolic encephalopathy, and shock. Addisonian crisis, also known as adrenal crisis or acute adrenal insufficiency, is an endocrinologic emergency with a high mortality rate secondary to physiologic derangements from an acute deficiency of the adrenal hormone cortisol, requiring immediate recognition and treatment to avoid death.
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