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