Skip to main content

Acute Adrenal Insufficiency

  • Chapter
  • First Online:
Endocrine Emergencies

Part of the book series: Contemporary Endocrinology ((COE,volume 74))

  • 2777 Accesses

Abstract

This chapter defines the criteria for the diagnosis of adrenal insufficiency, its diagnosis, and the various modalities of treatment. Pitfalls in the diagnosis process are discussed, and the standards of practice are outlined.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bouachour C, Tirot P, Gouello JP, et al. Adrenocortical function during septic shock. Intensive Care Med. 1995;21:57–62.

    Article  PubMed  CAS  Google Scholar 

  2. Pearson OH et al. Clinical and metabolic studies of bilateral adrenalectomy for advanced cancer in man. Surgery. 1953;34:543–56.

    PubMed  CAS  Google Scholar 

  3. Lipsett MB, Pearson OH. Pathophysiology and treatment of adrenal crisis. N Engl J Med. 1956;254:511–4.

    Article  PubMed  CAS  Google Scholar 

  4. Melby JC, Spink WW. Comparative studies in adrenal cortisol function and cortisol metabolism in healthy adults and in patients with shock due to infection. J Clin Invest. 1958;37:1791–7.

    Article  PubMed  CAS  Google Scholar 

  5. Jurney TH, Cockrell JL, Lindberg JS, et al. Spectrum of serum cortisol response to ACTH in ICU patients. Chest. 1987;92:292–5.

    Article  PubMed  CAS  Google Scholar 

  6. Span LFR, Hermus AC, Bartelink AK, et al. Adrenocortial function: An indicator of severity of disease and survival in chronic critically ill patients. Intensive Care Med. 1992;18:93–6.

    Article  PubMed  CAS  Google Scholar 

  7. Beisel WR, Bruton J, Anderson KO, Sawyer WD. Adrenocortical responses during tularemia in human subjects. J Clin Endocrinol Metab. 1967;27:61–9.

    Article  PubMed  CAS  Google Scholar 

  8. Naito Y, Fukata J, Tamai S, et al. Biphasic changes in hypothalomo-pituitary-adrenal function during the early recovery period after major abdominal surgery. J Clin Endocrinol Metab. 1991;73:111–7.

    Article  PubMed  CAS  Google Scholar 

  9. Udelsman R, Loriaux DL, Chrouros GP. Reevaluation of the role of glococorticoids in surgical stress. Surg Forum. 1985;36:18–20.

    CAS  Google Scholar 

  10. Kehlet H, Binder CH. Adrenorcortical function and clinical course during and after surgery in glucocorticoid treated patients. Br J Anesthesia. 1973;45:1043–8.

    Article  CAS  Google Scholar 

  11. Plumpton FS, Besser GM. Corticosteroid treatment and surgery. Anesthesia. 1969;24:3–11.

    Article  CAS  Google Scholar 

  12. Kehlet H et al. Short ACTH test in assessing hypothalamic-pituitary-adrenocortical function. Br Med J. 1976;7:249–51.

    Article  Google Scholar 

  13. May ME, Carey RM. Rapid adrenocortrotropic hormone test in practice. Am J Med. 1985;79:679–84.

    Article  PubMed  CAS  Google Scholar 

  14. Speckart PF, Nicolloff JT, Bethune JE. Screening for adrenocortical insufficiency with Cosyntropin® (synthetic ACTH). Arch Intern Med. 1971;128:761–3.

    Article  PubMed  CAS  Google Scholar 

  15. Hjortrup A, Kehlet H, Lindholm J, Stentaft P. Value of the 30-minute adrenocorticotropin (ACTH) test in demonstrating hypothalamic-pituitary-adrenocortical insufficiency after acute ACTH deprivation. JCEM. 1983;57:668–70.

    PubMed  CAS  Google Scholar 

  16. Loriaux L. Glucocorticoid therapy in the intensive care unit. New Engl J Med. 2004;350:1601.

    Article  PubMed  CAS  Google Scholar 

  17. Oelker W. Dose response aspects in the clinical assessment of the HPA axis, and the low-dose adrenocorticotropin tests. Eur J Endocrinol. 1998;135:27–33.

    Article  Google Scholar 

  18. Loriaux L, Fleseriu M. Relative adrenal insufficiency. Curr Opin Endocrinol Diabetes Obes. 2009;16(5):392–400.

    Article  PubMed  Google Scholar 

  19. Beishuizen A, Thijs LG. Relative adrenal failure in intensive care: An identifiable problem requiring treatment? Best Pract Res Clin Endocrinol Metab. 2001;15:513–31.

    Article  PubMed  CAS  Google Scholar 

  20. Marik PE et al. Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients. Crit Care Med. 2008;36(6):1937–49.

    Article  PubMed  CAS  Google Scholar 

  21. Sprung CL, Goodman S, Weiss YG. Steroid therapy of septic shock. Crit Care Clin. 2009;25:825–34.

    Article  PubMed  CAS  Google Scholar 

  22. Cohen J, Venkatesh B. Relative adrenal insufficiency in the intensive care population; background and critical appraisal of the evidence. Anaesth Intensive Care. 2010;38:425–36.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lynn Loriaux M.D., Ph.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Loriaux, L. (2014). Acute Adrenal Insufficiency. In: Loriaux, L. (eds) Endocrine Emergencies. Contemporary Endocrinology, vol 74. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-697-9_1

Download citation

  • DOI: https://doi.org/10.1007/978-1-62703-697-9_1

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-696-2

  • Online ISBN: 978-1-62703-697-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics