Adrenal Disease - Addisonian/Adrenal Crisis

Question 1

What is Addisonian Crisis?

Answer 1

An acute presentation of severe Addison’s disease - absence of steroid hormones leads to a life-threatening presentation.

Question 2

Aetiology of Addisonian Crisis (3).

Answer 2

1. Sepsis/Surgery - Acute Exacerbation of Chronic Insufficiency.
2. Adrenal Haemorrhage - Waterhouse Friderichsen Syndrome (Fulminant Meningococcaemia).
3. Steroid Withdrawal.

Question 3

Clinical Presentation of Addisonian Crisis (3).

Answer 3

1. Reduced Consciousness.
2. Hypotension.
3. Hypoglycaemia, Hyponatraemia, Hyperkalaemia.

Question 4

Management of Addisonian Crisis (3).

Answer 4

1. Parenteral Steroids - Hydrocortisone 100mg IV/IM 6 hourly until stable and replace after 24 hours.
2. IV Fluid Resuscitation.
3. Correct Hypoglycaemia.