Adrenal crisis

Diagnosis

- fever, hypoTN (refractory to fluids), hyperpigmentation by increased ACTH

- cushingoid look by chronic steroid use

- think about in kids with congenital adrenal hyperplasia (CAH) who present with shock

Workup

labs (istat)

- hypoNa (by increased ADH)

- hyperK

- azotemia

Treatment

Steroids, Steroids, Steroids

2 mg/kg of hydrocortisone

- Fludrocort, not as necessary since hydrocort has glucocorticoid activity

Treat underlying cause

Source

7/2/09 PANI (Adapted from Mistry)