What Causes Addisonian Crisis and Can It Be Prevented?

Addisonian Crisis, also known by the name of Adrenal Crisis, is an extremely serious medical condition which has the potential to pose a threat to the life of the affected individual. This condition develops due to severe adrenal insufficiency. An individual is said to have adrenal insufficiency when the adrenal gland does not function normally and there excessive depletion of cortisol levels in the body. Cortisol is a hormone which is required by the body to carry out various bodily functions. If the level of cortisol is low then the body goes into a virtual shutdown mode.^[2]

Cortisol also decreases the stress levels of an individual. Thus an individual who has depleted levels of cortisol will not be able to cope up with stress better than normal people. As the condition progresses, the cortisol levels become so low that the individual starts experiencing symptoms some of which are quite serious and require emergent medical attention.^[2]

Studies suggest that around 5-6% of people with Addisonian Crisis tend to succumb to this condition which is considered quite high since it is a treatable and preventable disease. Some of the presenting features of Addisonian Crisis include lethargy and weakness. Mental impairment in the form of confusion and psychosis can also be seen in people with Addisonian Crisis.^[2]

Neurological manifestations like slurred speech are also quite common in Addisonian Crisis. The affected individual will also have loss of appetite, fever, chills, and sweating. The blood pressure of the individual will go down to abnormally low levels and the pulse rate will be very high. There may also be loss of consciousness and the individual may go into coma due to Addisonian Crisis. This article highlights some of the potential causes of Addisonian Crisis and ways to prevent it.^[2]

Addisonian Crisis is primarily caused by adrenal insufficiency. Thus it is important to understand what may cause adrenal insufficiency. There are basically two categories of adrenal insufficiency namely primary and secondary. Autoimmune disorders, certain classes of medications, infections, or adrenal hemorrhage are some of the causes of primary adrenal insufficiency.^[1]

The secondary form of this disorder is caused when not enough ACTH is produced by the pituitary gland in the brain. This may be caused due to head trauma, prolonged steroid use, or pituitary tumors. When adrenal insufficiency is left untreated it results in the symptoms of Addisonian Crisis.^[1]

Addisonian Crisis may also develop due to immense stress as a result of an impending surgery, physical or emotional trauma, or overexertion at work or at home. Additionally, people who have a known diagnosis of Addison’s disease are also at risk for developing Addisonian Crisis, especially in cases where the condition has not yet been diagnosed or treated.^[1]

According to the National Institute of Diabetes and Digestive Kidney Diseases around 100 out of a minion people have Addison’s disease. This data is collected from all the developed nations around the world. The institute also informs that majority of the cases of Addison’s disease are caused due to autoimmune disorders. Some of the other causes of this disease include physical trauma, severe bouts of dehydration, viral infections affecting the stomach, surgery involving the adrenal glands.^[2]

In some cases Addison disease is also caused when the pituitary gland does not function normally resulting in reduced production of ACTH causing Addisonian Crisis. Some people who undergo surgery under general anesthesia are also at risk for developing a condition like Addison disease with Addisonian Crisis. There have also been cases where severe allergic reactions have led to individuals developing Addison’s disease.^[2]

Complications during pregnancy are also one of the reasons behind some females reporting symptoms of Addison’s disease and being at risk for Addisonian Crisis. A study done in 2015 in which people were asked to inform the factors which triggered symptoms of Addisonian Crisis where around 400 people participated showed that gastrointestinal infection and emotional trauma were the leading causes of the symptoms of Addisonian Crisis. As the recurrence rate of Addisonian Crisis is quite high people with a prior history of this condition are more likely to develop it once again if not treated on time.^[2]

Addisonian Crisis is definitely preventable provided adequate precautions are taken especially in people who have a known diagnosis of adrenal insufficiency. It is essential for people to keep a close eye on the onset of symptoms and to go to the emergency department if they feel that the symptoms are worsening.^[2]

It is also important to manage triggering mechanism such as stress and cope with it in a healthful manner like yoga. Taking medications as prescribed for adrenal insufficiency is a must to prevent an onset of Addisonian Crisis. It would also help to consult with a physician on whether an individual can take extra medication and if yes then how much should be taken if there is excessive stress or in cases of being affected by an infection to prevent Addisonian Crisis.^[2]

Individuals who are at risk for Addisonian Crisis should always carry an injectable steroid and should take it immediately when start experiencing symptoms and not to wait till the condition worsens. Once taking the injection, a trip should be made to the treating physician or to the nearest emergency room for further management of the condition and prevent further complications.^[2]

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Also Read:

• What is Addisonian Crisis and How is it Treated?