Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-24T02:03:55.688Z Has data issue: false hasContentIssue false

42 - Adrenal Crisis

from Section 9 - Endocrine Emergencies

Published online by Cambridge University Press:  02 November 2023

By
Raymond Hou  and
Daniel Rolston
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
Get access

Summary

  • Adrenal insufficiency can be either primary, resulting from destruction of the adrenal gland, or secondary, resulting from a deficiency of ACTH (adrenocorticotropic hormone, corticotropin).

  • Adrenal crisis is either the acute development of severe adrenal insufficiency or a rapid deterioration from baseline chronic adrenal insufficiency (which is often insidious) brought on by a stressor.

  • The adrenal gland (made up of cortex and medulla) produces three categories of steroids: glucocorticoids (cortisol), mineralocorticoids (aldosterone) and gonadocorticoids (sex hormones). Aldosterone levels change in response to volume status and sodium intake. Aldosterone maintains sodium and potassium concentration and regulates water balance.

Keywords

cortisolglucocorticoidsmineralocorticoidshypotensionendocrine
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 433 - 442
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Annane, BE. Corticosteroids in the treatment of severe sepsis and septic shock in adults: a systematic review. JAMA 2009;301:2362–2375.CrossRefGoogle ScholarPubMed
Fang, F, Zhang, Y, Tang, J, et al. Association of corticosteroid treatment with outcomes in adult patients with sepsis: a systematic review and meta-analysis. JAMA Intern Med 2019;179(2):213–223. https://doi.org/10.1001/jamainternmed.2018.5849CrossRefGoogle ScholarPubMed
Salvatori, R. Adrenal insufficiency. JAMA 2005;294:2481–2488.CrossRefGoogle ScholarPubMed
Torrey, SP. Recognition and management of adrenal emergencies. Emerg Med Clin North Am 2005;23:687–702, viii.CrossRefGoogle ScholarPubMed
Zull, D. Thyroid and adrenal disorders. In: Marx, JA, Hockberger, RS, Walls, RM, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice, 7th ed. Philadelphia, PA: Mosby Elsevier, 2010.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×