Adrenal Insufficiency
Introduction Relative Adrenal Insufficiency Addisonian crisis Introduction See: Adrenal insufficiency (Addison Disease) . Relative Adrenal Insufficiency ICD-10 code: E27.4/E27.9 Description This is a transient, disproportionate reduction of glucocorticoids in relation to the severity of stress. Note that absolute cortisol levels may be normal. The prevalence of relative adrenal insufficienc
Relative Adrenal Insufficiency
Introduction
See: Adrenal insufficiency (Addison Disease).
Relative Adrenal Insufficiency
ICD-10 code: E27.4/E27.9
Description
This is a transient, disproportionate reduction of glucocorticoids in relation to the severity of stress. Note that absolute cortisol levels may be normal. The prevalence of relative adrenal insufficiency is high in septic shock. See: Sepsis in ICU for more details.
Medicine Treatment
See: Sepsis in ICU
Addisonian crisis
ICD-10 code: E27.2
Description
Acute adrenal (Addisonian) crisis is a potentially fatal condition that occurs because of insufficient circulating corticosteroids. It is usually caused by impairment of the hypothalamic-pituitary axis, but may also be due to anatomic destruction of the adrenal gland (e.g. in disseminated tuberculosis or fungal infections, or other disease that infiltrate the adrenal gland), adrenal haemorrhage (e.g. septicaemia induced Waterhouse-Friderichsen syndrome), or more commonly, steroid withdrawal.
General Measures
Acute adrenal insufficiency is an emergency and requires immediate therapy.
Principles of management include:
- Treating precipitating cause.
- Providing organ support.
Medicine Treatment
- Hydrocortisone, IV, 100 mg 6 hourly.
Standard Treatment Guidelines and Essential Medicines List for South Africa Adult Hospital _Chapter 23: Adult Critical Care_NEMLC Medicine Recommendations Review Cycle_ 2020_2023