Background
Adrenal insufficiency is a rare disease caused by either
primary adrenal failure (Addison disease) or by impairment
of the hypothalamic-pituitary-adrenal axis. Steroid
replacement therapy normalises quality of life, however,
adherence can be problematic.
Objective
This article provides information on adrenal insufficiency
focusing on awareness of initial symptoms and on
risk scenarios, emergency management and baseline
investigations, complete investigations and long term
management.
Discussion
Early recognition of adrenal insufficiency is essential
to avoid associated morbidity and mortality. Initial
diagnosis and decision to treat are based on history and
physical examination. Appropriate management includes
emergency resuscitation and steroid administration. Initial
investigations can include sodium, potassium and blood
glucose levels. However, complete investigations can be
deferred. Specialist advice should be obtained and long
term management includes a Team Care Arrangement. For
patients, an emergency plan and emergency identification
are essential.
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