Addisonian crisis

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• Addisonian crisis :
•  (also known as  Adrenal crisis  and acute adrenal insufficiency) is a
medical emergency and potentially life-threatening situation requiring
immediate emergency treatment.
• It is a number of symptoms that indicate severe adrenal insufficiency
caused by insufficient levels of the hormone cortisol.
•  This may be the result of either previously undiagnosed or untreated 
Addison's disease.
• Adrenal crisis is caused by a deficiency of cortisol resulting from:
•  Addison's disease
•  congenital adrenal hyperplasia (CAH)
• Infection (TB, sarciodosis )
• pituitary disorders (such as Sheehan's syndrome, pituitary adenoma, hypopituitarism ) causing
failure to activate the adrenal glands.

• Rapid cortison stop

Signs and symptoms

• Sudden penetrating pain in the legs, lower back or abdomen

• Confusion, psychosis, slurred speech
• Severe lethargy
• Convulsions
• Fever
• Hypotension (low blood pressure)
• Severe vomiting and diarrhea, resulting in dehydration
• Syncope (loss of consciousness and ability to stand)
• Hyperkalemia (elevated potassium level in the blood)
• Hypercalcemia (elevated calcium level in the blood
• Hypoglycemia (reduced level of blood glucose)
• Hyponatremia (low sodium level in the blood)
• Hypotension (low blood pressure)
• Hypothyroid (low T4 level)
Diagnosis

•ACTH (cosyntropin) stimulation test

•Cortisol level (to assess the level of glucocorticoids)
•Fasting blood sugar
•Serum potassium (to assess the level of mineralocorticoids)
•Serum sodium
Thank you