Addison's disease: what if I have an Addison's crisis?
Q: I have been lucky enough not to experience an Addison's disease crisis but would like to know what happens and what I and those around me should do if such a crisis occurs.
A: Clinical features of acute adrenal insufficiency may occur over a few days with the patient ending up acutely ill, or may occur suddenly, especially if there is a sudden drop in blood pressure. The acute situation is most prevalent if the patient with known adrenal insufficiency is deprived of steroid replacement.
The symptoms which occur include the following.
- Nausea, vomiting and acute abdominal pain.
- Weight loss, usually rapid.
- Dizziness and fainting especially on standing up (due to a fall in blood pressure).
- Generalised weakness and fatigue.
- Symptoms of low blood sugar (hypoglycaemia) may also occur, which include sweating and palpitations.
The most important thing to remember is to try to prevent acute adrenal insufficiency by not forgetting to take corticosteroids and to have injectable corticosteroids in case of vomiting.
Once acute adrenal insufficiency occurs, it is essential that the patient receive injectable corticosteroids which can be administered by relatives in the first instance, but the doctor should also be consulted as soon as possible. If the patient is vomiting or dehydrated, admission to hospital and administration of intravenous fluids is essential.
Last Reviewed: 03 June 2007
