Addisonian crisis

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Addisonian Crisis is a life-threatening emergency caused by insufficient adrenocortical hormones or a sudden sharp decrease in these hormones.

Addisonian Crisis occurs primarily in patients with adrenocortical insufficiency, such as those suffering from Addison's disease. It can be triggered by stress (e.g. from infection, trauma, surgery, hemorrhage, or psychological distress). Addisonian crisis can also be triggered following sudden withdrawal of corticosteroid hormone replacement therapy, after adrenal surgery, or following sudden pituitary gland destruction.

During an Addisonian crisis, severe manifestations of glucocorticoid and mineralocorticoid deficiency are exhibited. These include:

- hypotension (particularly postural)
- tachycardia (rapid heart rate)
- dehydration
- hyponatremia (reduced serum sodium levels)
- hyperkalemia (elevated serum potassium levels)
- hypoglycemia (low blood sugar levels)
- fever
- weakness
- confusion
- nausea
- vomiting
- diarrhea
- vague abdominal pain

Hypotension may lead to shock. The circulatory collapse associated with adrenal insufficiency is often unresponsive to the usual treatments (vasopressors and fluid replacement).