Adrenal Insufficiency

CRISIS

Abdominal/Flank Pain

Dehydration Dizziness/Light headednessFatigueMigraine/Headache

Fever

Joint Pain

LOW BLOOD PRESSURE

Loss of appetite

Nausea

Profound Weakness

Low Blood Sugar

Rapid Heart Rate

Rapid Respiratory Rate

Shaking Chills

Unusual/excessive Sweating

Vomiting

CONFUSION/COMA

RESUSCITATION / DEATH

Brain Injury

Organ Damage

Stroke

Heart Attack

Low Cortisol

Fatigue

Muscle Weakness

Nausea

Diarrhea

Low Stress Tolerance

Anxiety

Mood Changes

Migraine/Headache

Increased Heart Rate

Sweating

Dehydration Diziness/Disorientation

Muscle aches

Joint Pain

Definition and Gradingof Adrenal Crisis

Definition

Definition: (A): Major impairment ofgeneral health with at least two of thefollowing signs/symptoms: Hypotension (systolic blood pressure !100 mmHg)Nausea or vomiting Severe fatigue FeverSomnolence Hyponatraemia (<132 mmol/l) or hyperkalaemiaHypoglycaemia

Definition: (B): Parenteral glucocorticoid (hydrocortisone) administrationfollowed by clinical improvement

Grade 1: outpatient care onlyGrade 2: hospital care (general ward)Grade 3: admission to intensive care unitGrade 4: death from adrenal crisis (with or without parenteral glucocorticoid administration)

Grading

by Professor Bruno Allolio, Professor of Medicine atthe University of Würzburg