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42 - Adrenal Crisis
from Section 9 - Endocrine Emergencies
- By Raymond Hou, Daniel Rolston
Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
Book:

Practical Emergency Resuscitation and Critical Care

Published online:

02 November 2023

Print publication:

23 November 2023, pp 433-442
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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.