Conduct protocol in emergency: Acute adrenal insufficiency

Fares, Adil Bachir; Santos, Rômulo Augusto dos

doi:10.1590/1806-9282.62.08.728

Cited by 4 publications

(4 citation statements)

References 11 publications

(32 reference statements)

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“…In patients with newly diagnosed (or suspected) adrenal insufficiency, baseline blood samples should be drawn immediately to measure cortisol and adrenocorticotropic hormone levels before hydrocortisone administration. However, this is a critical condition; thus, a time-consuming diagnostic workup should be avoided to ensure prompt initiation of treatment even before diagnostic confirmatory testing is completed (4, 11, 12). A diagnostic delay may result in potentially fatal consequences following the failure of physiological compensation to the invasive stress.…”

Section: Discussionmentioning

confidence: 99%

Acute Adrenal Insufficiency Precipitated by the Discontinuation of a Betamethasone and Dextrochlorpheniramine Combination: The Diagnostic Utility of an Echocardiographic Assessment of Systemic Vascular Resistance

et al. 2019

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A 72-year-old woman with primary biliary cholangitis was admitted to our hospital with heart failure with a preserved ejection fraction. An accidental right ventricular perforation that occurred during an endomyocardial biopsy precipitated cardiogenic shock. Despite successful surgical treatment, she demonstrated progressive hemodynamic deterioration, which was resistant to the administration of high-dose catecholamines. She was diagnosed with acute adrenal insufficiency, which was attributed to the discontinuation of Celestamine Ⓡ (betamethasone/dextrochlorpheniramine combination) just after the perforation. Prompt intravenous administration of hydrocortisone (150 mg/day) led to hemodynamic stabilization. The serial noninvasive assessment of systemic vascular resistance using transthoracic echocardiography was instrumental in detecting acute adrenal insufficiency in this case.

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Section: Discussionmentioning

confidence: 99%

Acute Adrenal Insufficiency Precipitated by the Discontinuation of a Betamethasone and Dextrochlorpheniramine Combination: The Diagnostic Utility of an Echocardiographic Assessment of Systemic Vascular Resistance

et al. 2019

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“…Serum cortisol level ≥ 100 pg/mL confirms the diagnosis of Addison's syndrome. Serum cortisol value of <10 pg/mL confirms diagnosis of secondary AI [35][36][37][38][39].…”

Section: Laboratory Investigationsmentioning

confidence: 99%

“…Adrenal insufficiency was first described by Thomas Addison in 1855 and was popularly known as Addison's disease. This disorder can occur either due to failure of the adrenal gland or impairment of the hypothalamic-pituitary axis [36]. Clinically this syndrome is characterized by weakness, fatigue, anorexia, abdominal pain, weight loss, orthostatic hypotension, and salt craving.…”

Section: Introduction and Definitionmentioning

confidence: 99%

“…Tertiary adrenal insufficiency results from processes that involve the hypothalamus and interfere with secretion of corticotropin-releasing hormone, arginine vasopressin, or both. Suppression of the hypothalamic-pituitary-adrenal (HPA) axis by long-term administration of high doses of glucocorticoids is the most common cause [9,36,38].…”

Section: Introduction and Definitionmentioning

confidence: 99%

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Pathology Associated with Hormones of Adrenal Cortex

Nigam¹,

Vanikar²,

Patel³

et al. 2020

Mitochondria and Brain Disorders

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Adrenal gland is an endocrine organ comprising of an outer cortex and inner medulla. These secrete various hormones that have a vital role in maintaining the normal homeostasis of the body. Lesions of adrenal cortex are quite common to encounter and most of these are related to the hormones secreted by three layers of adrenal cortex: the zona glomerulosa, the zona fasciculata, and the zona reticularis. Also it is very infrequent to encounter metastatic lesions in the adrenal glands too. So it is very important as a part of a clinician as well as a pathologist to know the pattern in which these hormones are secreted along with their physiological roles. Thus this chapter includes the disease that are related to excess as well as deficiencies of the hormones secreted by adrenal cortex. The chapter also includes various genetic syndromes that are associated with the disorders associated with hormones of adrenal cortex. The last part of the chapter includes a brief description of various benign as well as malignant lesions, the pathological as well as the etiological aspects and the hormonal abnormalities associated. This chapter thus mainly focuses on the pathology associated with the adrenal cortex and hormones secreted by the various layers of adrenal cortex.

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Abdominal Pain Mimics

Murali

Hayek

2021

Emergency Medicine Clinics of North America

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Conduct protocol in emergency: Acute adrenal insufficiency

Cited by 4 publications

References 11 publications

Acute Adrenal Insufficiency Precipitated by the Discontinuation of a Betamethasone and Dextrochlorpheniramine Combination: The Diagnostic Utility of an Echocardiographic Assessment of Systemic Vascular Resistance

Acute Adrenal Insufficiency Precipitated by the Discontinuation of a Betamethasone and Dextrochlorpheniramine Combination: The Diagnostic Utility of an Echocardiographic Assessment of Systemic Vascular Resistance

Pathology Associated with Hormones of Adrenal Cortex

Abdominal Pain Mimics

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