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Adrenal crisis is a serious, life-threatening complication of adrenal insufficiency. Hypotension , or hypovolemic shock , is the main symptom of adrenal crisis, other indications and symptoms include weakness , anorexia , nausea , vomiting, fever, fatigue , abnormal electrolytes , confusion , and coma. [ 19 ]
An "adrenal crisis" or "Addisonian crisis" is a constellation of symptoms that indicates severe adrenal insufficiency. This may be the result of either previously undiagnosed Addison's disease, a disease process suddenly affecting adrenal function (such as adrenal hemorrhage ), or an intercurrent problem (e.g., infection, trauma) in someone ...
Adrenal insufficiency can also result when a patient has a brain mass in the pituitary gland (e.g. pituitary adenoma, craniopharyngioma) which can take up space and interfere with the secretion of pituitary hormones such as ACTH, therefore leading to decreased adrenal stimulation (secondary adrenal insufficiency). [2]
Tumors on the pituitary gland or cancer metastasis can also cause adrenal insufficiency. [10] Exogenous steroid use is the most frequent cause of adrenal insufficiency, and those who use steroids also run the risk of experiencing an adrenal crisis. Adrenal crisis can be triggered by abrupt, and frequently unintentional, steroid withdrawal.
Waterhouse–Friderichsen syndrome (WFS) is defined as adrenal gland failure due to hemorrhages in the adrenal glands, commonly caused by sepsis. Typically, the bacteria responsible for triggering the bleeding is Neisseria meningitidis. [1] The bacterial infection leads to massive bleeding into one or both adrenal glands. [2]
Morning serum cortisol levels are typically the first step in the diagnostic work-up, but this test is only significant if values are extremely low, adrenal insufficiency is almost certain with values below 3 μg/dl, or it can be excluded with values in the upper half of the normal range. Cortisol levels above 19 g/dl almost always rule out ...
Congenital adrenal hyperplasia, diseases in the production of cortisol; Nelson's syndrome, the rapid enlargement of the ACTH producing pituitary after the removal of both adrenal glands; Adrenoleukodystrophy, can be accompanied by adrenal insufficiency; West syndrome ("infantile spasms"), a disease where ACTH is used as a therapy
Nelson's syndrome is a disorder that occurs in about one in four patients who have had both adrenal glands removed to treat Cushing's disease. [1] In patients with pre-existing adrenocorticotropic hormone ()-secreting pituitary adenomas, loss of adrenal feedback following bilateral adrenalectomy can trigger the rapid growth of the tumor, leading to visual symptoms (e.g. bitemporal hemianopsia ...