Acute adrenal crisis

Sylvia Šefčík, MD, Martin Šefčík, MD, Ivana Kravárová, Kateřina Dvořáková

Acute adrenal crisis is a condition, which arise from an adrenal cortex insufficiency. It can develop because of untreated Addison disease or abruptly as a result of many other causes. Patients with the adrenal crisis need an intensive health care and adequate treatment, as the condition can be potentially life-threatening. They must be thoroughly informed about their disease and need to precisely follow doctors instructions. In this algorithm, we will look at the patient examination, diagnosis and therapy including complications management.


Karel Starý, MD Chief Physician, outpatient's endocrinology clinic, assistant professor at Internal gastroenterology clinical, University Hospital Brno, Brno, Czech Republic

Hypocorticism is a relatively common problem in medicine and many doctors of various specialties come across some form of this complication. The causes of hypocortisolism are very varied. Today one of the reasons could be autoimmune adrenalitis which is triggered by modern pharmacotherapy. We also commonly see hypocorticism as a result of trauma, infection, sepsis, or adrenal tumor infiltration. Adrenocorticotropic depression commonly accompanies chronic corticosteroid therapy and pituitary lesions of any cause. The Addison crisis is a life-threatening condition that accounts for 10-25% of all hypocorticalisms. The typical symptoms are relatively non-specific and therefore it is extremely important to think about this possibility. The authors of this algorithm in cooperation with the Akutně.cz platform offer teaching material that should be used to verify the doctor's readiness to think about Addison’s disease during the first contact with the patient. This algorithm verifies knowledge of recognizing the typical symptoms, changes in the internal environment, and basic treatment procedures. The didactic level is very good and I am sure it is a good and inspiring material to verify practical knowledge.

Češka, R. et al. Interna, 2nd edition. Praha : TRITON, 2015. ISBN 978-80-7387-895-5. Resuscitation council UK. Advanced life support, 7th edition. London : Resuscitation council UK, 2016. ISBN 978-1-903812-30-3

DINEEN, Rosemary, Christopher J THOMPSON and Mark SHERLOCK. Adrenal crisis: prevention and management in adult patients. Ther Adv Endocrinol Metab. [online]. 13.6.2019 [acc. 2022-05-03]. Available at: doi:10.1177/2042018819848218

inserted: 1. 6. 2022 | last modified on: 2. 6. 2022