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Primary adrenal insufficiency predisposes to higher risk of death, mostly due to infection, cardiovascular disease, and adrenal crisis. [2] Delayed diagnosis can impair quality of life, and lack of treatment brings high mortality. [2] However, with proper diagnosis, monitoring, and treatment, people with adrenal insufficiency can live normally. [3]
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 hemorrhage characteristic of the Waterhouse–Friderichsen syndrome has been identified in several autopsies of patients who died of sepsis secondary to capnocytophaga canimorsus infection. [8] Viruses may also be implicated in adrenal problems: Cytomegalovirus can cause adrenal insufficiency, [9] especially in the immunocompromised.
When a person with adrenal insufficiency is known to be exhibiting symptoms of an adrenal crisis, treatment begins before diagnostic testing. [14] When adrenal insufficiency is suspected a blood sample can be collected to test serum cortisol and ACTH levels, while treatment begins during the wait for results. Once an acutely ill person has ...
[2] [7] However, because most affected males will demonstrate adrenal insufficiency, early discovery and treatment of this symptom could potentially prevent complications and allow these patients to be monitored for other treatment in the future, depending on the progression of their disease. [11]
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 ]
The diagnosis of this condition involves examination by a health provider. Clinical signs may lead to the diagnosis such as the lack of tears and digestive issues, such as acid reflux disease in infancy as well as symptoms of adrenal insufficiency such as frequent bouts of low blood sugars are highly suggestive of the disorder.
The best known feature that suggests a possible underlying adrenal insufficiency is low blood pressure despite resuscitation with intravenous fluids, requiring vasopressor drugs. [4] These patients typically display tachycardia and other signs of hyperdynamic shock. [6]
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