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Updated: Jun 13, 2026
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
[Pediatric emergency: adrenal insufficiency and adrenal crisis]
Alicia Martínez1, Titania Pasqualini, Mirta Stivel
1Centro de Investigaciones Endocrinológicas, CONICET, Buenos Aires. amartinez@cedie.org.ar
Insights
Adrenal insufficiency impairs hormone secretion, causing critical symptoms like hypotension and hypoglycemia. Prompt treatment with fluids and glucocorticoids is vital for survival and managing this endocrine disorder.
Area of Science:
- Endocrinology
- Internal Medicine
Context:
- Adrenal insufficiency involves deficient adrenocortical hormone production.
- It presents with diverse, often nonspecific symptoms.
- Primary and secondary causes necessitate distinct management approaches.
Purpose:
- To outline the critical aspects of recognizing and managing adrenal insufficiency and its crisis.
- To emphasize the importance of timely intervention for patient survival.
Summary:
- Adrenal insufficiency is characterized by impaired adrenocortical hormone secretion, leading to symptoms such as anorexia, vomiting, weakness, hypotension, hypoglycemia, hyponatremia, and hyperkalemia.
- Urgent management of adrenal crisis involves fluid resuscitation, hypoglycemia correction, and glucocorticoid replacement therapy.
- Following initial stabilization, maintenance corticosteroid therapy is essential, with mineralocorticoid replacement considered as needed.
Impact:
- Highlights the life-threatening nature of adrenal crisis.
- Underscores the necessity of prompt diagnosis and treatment protocols.
- Provides a concise overview for healthcare professionals managing adrenal insufficiency.
Abstract:
Adrenal insufficiency is defined by impaired secretion of adrenocortical hormones. It is classified upon the etiology in primary and secondary. Rapid recognition and therapy of adrenocortical crisis are critical to survival. Patients often have nonspecific symptoms: anorexia, vomiting, weakness, fatigue and lethargy. They are followed by hypotension, shock, hypoglicemia, hyponatremia and hyperkalemia. All patients with adrenal insufficiency require urgent fluid reposition, correction of hypoglycemia and glucocorticoid replacement, in order to avoid serious consequences of adrenal crisis. After initial crisis treatment, maintenance dose of corticoids should be indicated. Mineralocorticoids replacement, if necessary, should also be initiated.
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