Acute adrenal insufficiency (adrenal or Addisonian crisis)

Acute adrenal insufficiency (adrenal or Addisonian crisis)

This is a medical emergency . Owing to its non-specific features (shock with some or all of the following: fever, nausea, vomiting, abdominal pain, hypoglycaemia and electrolyte imbalance), it can be di ffi cult to diagnose. It is also rapidly fatal unless prompt and appropriate treatment is instituted early in its course. Typically there is a precipitating illness that may unmask longstanding adrenal insu ffi ciency or a history of trauma or severe sepsis that result in adrenal haemorrhage or infarction (Waterhouse–Friderichsen syndrome), respectively . Because intestinal symptoms and fever are frequent, Addisonian crisis may often be misdiagnosed as an acute abdominal emergency .