What is an Addisonian Crisis?

wiseGEEK Writer

Addison’s disease is a medical condition that causes the adrenal glands to under-produce the needed hormones of aldosterone and cortisol. In some cases, the disease is first diagnosed when people have an addisonian crisis, where steroid levels are so low they produce conditions like extreme hypotension, and altered blood sugar, potassium, and calcium levels. These crises can be life-threatening if not treated promptly, and anyone with Addison’s is subject to them at any time, especially under periods of significant mental or physical stress. There are ways to reduce likelihood of experiencing an addisonian crisis, but people with this condition need to watch carefully for signs of one and get prompt medical attention if symptoms begin to occur.

Extreme vomiting may be a sign of an addisonian crisis.
Extreme vomiting may be a sign of an addisonian crisis.

The main symptoms of an addisonian crisis are important to recognize. Many people notice strong and severe pain in the stomach, and this discomfort is also sometimes felt in the lower back and the legs. A crisis is usually marked by vomiting that is extreme, which would make it very difficult to take the needed steroid medicine orally. Diarrhea may also be present, and both vomiting and diarrhea can create significant dehydration.

The blood pressure of a person in an Addisonian crisis may become so low that they lose consciousness.
The blood pressure of a person in an Addisonian crisis may become so low that they lose consciousness.

Another symptom of an addisonian crisis is very low blood pressure, but most people may not be able to determine this at home. Should this condition be ignored, other symptoms can occur. People may lose consciousness and could lapse into coma. Given that a crisis can progress quickly, it’s strongly advised that people wear medic alert bracelets, as this helps doctors prevent crises by using extra hormones in emergency settings.

The main initial treatment for an addisonian crisis is injection of additional cortisol in the form of drugs like hydrocortisone. People who have been previously diagnosed with Addison’s usually carry syringes of this prescribed hormone with them, so they can use it at first signs of a crisis. Medical follow-up is needed, and many patients will require additional treatment. If the crisis is caught early, treatment usually takes the form of an infusion of electrolyte-balanced fluid with extra steroid medicine.

There are a number of circumstances under which those with Addison’s might have crises. If people have an infection, and especially if they run fevers, they may be more prone to a crisis. Surgery or sudden accidents could precipitate an addisonian crisis. Dehydration is just as concerning and may result in medically urgent situations. Essentially, anything that causes high physical or emotional stress may be likely to cause this complication of Addison’s disease; people with the illness need to identify areas of high stress in their life and learn to use preventative extra medication during these times, as directed by their physicians.

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