アジソン病クリーゼ
- fatigue, nausea, vomiting, and weight loss accompanying an acute attack of Addison's disease.
WordNet
- an unstable situation of extreme danger or difficulty; "they went bankrupt during the economic crisis"
- a crucial stage or turning point in the course of something; "after the crisis the patient either dies or gets better"
PrepTutorEJDIC
- (社会上・政治上の)『重大な事態』,『難局』,危機 / (人生の)重大な転機(岐路),重大事 / 最悪状態
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/11/13 14:33:01」(JST)
[Wiki en表示]
| Adrenal crisis |
| Classification and external resources |
| MedlinePlus |
000357 |
| eMedicine |
article/116716 article/765753 |
Adrenal crisis (also known as Addisonian crisis, Acute adrenal insufficiency) is a constellation of symptoms that indicate severe adrenal insufficiency caused by insufficient levels of cortisol.[1] This may be the result of either previously undiagnosed or untreated Addison's disease, a disease process suddenly affecting adrenal function (such as adrenal hemorrhage), or an intercurrent problem (e.g. infection, trauma) in someone known to have Addison's disease. It is a medical emergency and potentially life-threatening situation requiring immediate emergency treatment.
Contents
- 1 Causes
- 2 Presentation
- 3 Diagnosis
- 4 Treatment
- 5 Prevention
- 6 Epidemiology
- 7 References
- 8 External links
Causes[edit]
It is caused due to deficiency of cortisol.
Presentation[edit]
Signs and Symptoms[edit]
Characteristic symptoms are:[2]
- Sudden penetrating pain in the legs, lower back or abdomen
- Confusion, psychosis, slurred speech
- Severe lethargy
- Convulsions
- Fever
- Hyperkalemia (elevated potassium level in the blood)
- Hypercalcemia (elevated calcium level in the blood)
- Hypoglycemia (reduced level of blood glucose)
- Hyponatremia (low sodium level in the blood)
- Hypotension (low blood pressure)
- Severe vomiting and diarrhea, resulting in dehydration
- Syncope (loss of consciousness and ability to stand)
Diagnosis[edit]
Various investigations aid the diagnosis.
- ACTH (cosyntropin) stimulation test
- Cortisol level
- Fasting blood sugar
- Serum potassium
- Serum sodium
Treatment[edit]
Acute adrenal insufficiency is a medical emergency and needs to be treated with injectable hydrocortisone and fluid support.[1]
Prevention[edit]
Adrenal crisis is triggered by stress and hence people with adrenal insufficiency need to avoid stressful situations.
Epidemiology[edit]
Hahner et al investigated the frequency, causes and risk factors for adrenal crisis in patients with chronic adrenal insufficiency.[3] Annane et al's landmark 2002 study found a very high rate of relative adrenal insufficiency among the enrolled patients with septic shock.[4]
References[edit]
- ^ a b "Acute adrenal crisis (Addisonian crisis)". Endocrine Surgery Encyclopedia. UCLA Health System. Retrieved 14 August 2013.
- ^ "Addison's Disease". National Endocrine and Metabolic Diseases Information Service. Retrieved 14 August 2013.
- ^ Hahner, S.; Loeffler, M.; Bleicken, B.; Drechsler, C.; Milovanovic, D.; Fassnacht, M.; Ventz, M.; Quinkler, M.; Allolio, B. (2 December 2009). "Epidemiology of adrenal crisis in chronic adrenal insufficiency: the need for new prevention strategies". European Journal of Endocrinology 162 (3): 597–602. doi:10.1530/EJE-09-0884. PMID 19955259.
- ^ Annane, D. (20 August 2002). "Effect of Treatment With Low Doses of Hydrocortisone and Fludrocortisone on Mortality in Patients With Septic Shock". JAMA: The Journal of the American Medical Association 288 (7): 862–871. doi:10.1001/jama.288.7.862. PMID 12186604.
External links[edit]
- Acute adrenal crisis on PubmedHealth
- Adrenal Crisis on Patient.co.uk
- Katherine White (28. July 2004). "What to do in an emergency -Addisonian crisis". Addison's Disease Self Help Group (ADSHG).
- Addisonian crisis on rightdiagnosis.com
|
Endocrine pathology: endocrine diseases (E00–E35, 240–259)
|
|
Pancreas/
glucose
metabolism |
| Hypofunction |
- types:
- type 1
- type 2
- MODY 1 2 3 4 5 6
- complications
- coma
- angiopathy
- ketoacidosis
- nephropathy
- neuropathy
- retinopathy
- cardiomyopathy
- insulin receptor (Rabson–Mendenhall syndrome)
- Insulin resistance
|
|
| Hyperfunction |
- Hypoglycemia
- beta cell (Hyperinsulinism)
- G cell (Zollinger–Ellison syndrome)
|
|
|
Hypothalamic/
pituitary axes |
| Hypothalamus |
- gonadotropin
- Kallmann syndrome
- Adiposogenital dystrophy
- CRH (Tertiary adrenal insufficiency)
- vasopressin (Neurogenic diabetes insipidus)
- general (Hypothalamic hamartoma)
|
|
| Pituitary |
| Hyperpituitarism |
- anterior
- Acromegaly
- Hyperprolactinaemia
- Pituitary ACTH hypersecretion
- posterior (SIADH)
- general (Nelson's syndrome)
|
|
| Hypopituitarism |
- anterior
- Kallmann syndrome
- Growth hormone deficiency
- ACTH deficiency/Secondary adrenal insufficiency
- GnRH insensitivity
- FSH insensitivity
- LH/hCG insensitivity
- posterior (Neurogenic diabetes insipidus)
- general
- Empty sella syndrome
- Pituitary apoplexy
- Sheehan's syndrome
- Lymphocytic hypophysitis
|
|
|
| Thyroid |
| Hypothyroidism |
- Iodine deficiency
- Cretinism
- Congenital hypothyroidism
- Myxedema
- Euthyroid sick syndrome
|
|
| Hyperthyroidism |
- Hyperthyroxinemia
- Thyroid hormone resistance
- Familial dysalbuminemic hyperthyroxinemia
- Hashitoxicosis
- Thyrotoxicosis factitia
- Graves' disease
|
|
| Thyroiditis |
- Acute infectious
- Subacute
- De Quervain's
- Subacute lymphocytic
- Autoimmune/chronic
- Hashimoto's
- Postpartum
- Riedel's
|
|
| Goitre |
- Endemic goitre
- Toxic nodular goitre
- Toxic multinodular goiter
|
|
|
| Parathyroid |
| Hypoparathyroidism |
- Hypoparathyroidism
- Pseudohypoparathyroidism
- Pseudopseudohypoparathyroidism
|
|
| Hyperparathyroidism |
- Primary
- Secondary
- Tertiary
- Osteitis fibrosa cystica
|
|
|
| Adrenal |
| Hyperfunction |
- aldosterone: Hyperaldosteronism/Primary aldosteronism
- Conn syndrome
- Bartter syndrome
- Glucocorticoid remediable aldosteronism
- AME
- Liddle's syndrome
- 17α CAH
- cortisol: Cushing's syndrome (Pseudo-Cushing's syndrome)
- sex hormones: 21α CAH
- 11β CAH
|
|
Hypofunction/
Adrenal insufficiency
(Addison's, WF) |
- aldosterone: Hypoaldosteronism
|
|
|
| Gonads |
- ovarian: Polycystic ovary syndrome
- Premature ovarian failure
- testicular: enzymatic
- 5α-reductase deficiency
- 17β-hydroxysteroid dehydrogenase deficiency
- aromatase excess syndrome)
- Androgen receptor (Androgen insensitivity syndrome
- general: Hypogonadism (Delayed puberty)
- Hypergonadism
- Hypoandrogenism
- Hypoestrogenism
- Hyperandrogenism
- Hyperestrogenism
|
|
|
| Height |
- Dwarfism/Short stature
- Midget
- Laron syndrome
- Psychosocial
- Ateliosis
- Gigantism
|
|
| Multiple |
- Autoimmune polyendocrine syndrome multiple
- Carcinoid syndrome
- Multiple endocrine neoplasia
- Progeria
- Werner syndrome
- Acrogeria
- Metageria
- Woodhouse-Sakati syndrome
|
|
|
|
|
noco (d)/cong/tumr, sysi/epon
|
proc, drug (A10/H1/H2/H3/H5)
|
|
|
|
UpToDate Contents
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English Journal
- Laparoscopic bilateral cortical-sparing adrenalectomy for pheochromocytoma.
- Biteman BR1, Randall JA2, Brody F2.
- Surgical endoscopy.Surg Endosc.2016 Dec;30(12):5622-5623. Epub 2016 May 13.
- INTRODUCTION: Since laparoscopic adrenalectomy for pheochromocytoma was reported in 1992, the laparoscopic technique has largely replaced the open approach [4]. Numerous studies have demonstrated that the laparoscopic approach is associated with decreased blood loss, shorter hospitalization, faster
- PMID 27177950
- Adrenal crisis while on high-dose steroid treatment: what rheumatologist should consider?
- Üsküdar Cansu D1, Cansu GB2, Arik D3, Korkmaz C4.
- Rheumatology international.Rheumatol Int.2016 Nov 1. [Epub ahead of print]
- Steroid treatment is commonly recommended for autoimmune disorders in rheumatology practice. While adrenal crisis may occur upon existence of an inducing factor in patients with known or unknown adrenal insufficiency as well as in those with a suppressed hypothalamic-pituitary-adrenal (HPA) axis due
- PMID 27803964
- [Congenital Adrenal Hyperplasia in Adults].
- Vrbíková J.
- Vnitrni lekarstvi.Vnitr Lek.2016 Fall;62(Suppl 3):131-134.
- Congenital adrenal hyperplasia is a life-long disease requiring an integrated therapy. It may negatively influence the quality of life. In childhood, the main problems of the care of these patients involve sex determination and ensuring optimum growth and puberty. The therapeutic goals for adults ar
- PMID 27734706
Japanese Journal
- Proliferation, zonal maturation, and steroid production of fetal adrenal transplants in adrenalectomized rats
- TILL H.,METZGER R.,MEMPEL T.,BOEHM R.,JOPPICH I.
- Pediatric surgery international 16(4), 293-296, 2000-05-01
- NAID 10017059818
- Pre-Clinical Cushing's Syndrome with Body Weight Loss and Normal Circadian Rhythm of Blood Pressure
- Iwami Taku,Nakamura Tetsuya,Niwamae Nogiku [他],YAMAGISHI Takahiro,UTSUGI Toshihiro,NAGAI Ryozo
- Internal medicine 37(6), 528-533, 1998-06-00
- … Due to the lack of clinical symptoms and the risks of surgery, we emphasize the importance of careful assessment of the cortisol metabolism and scintigraphic scanning under dexamethasone suppression to avoid post-surgical Addisonian crisis.(Internal Medicine 37: 528-533, 1998) …
- NAID 10007010261
- Addisonian crisis and hypercalcaemia.
Related Links
- Medications People who are experiencing an Addisonian crisis typically get an immediate injection of hydrocortisone. If you visit an emergency room or doctor’s office, you may be given an injection through a vein, or in your muscles.
- Addisonian crisis information including symptoms, diagnosis, misdiagnosis, treatment, causes, patient stories, videos, forums, prevention, and prognosis. ... Addisonian crisis: Introduction Addison's disease is a condition where the ...