Addisonian crisis is the term used to describe an acute presentation of severe Addisons, where the absence of steroid hormones leads to a life threatening presentation.

Causes

• sepsis or surgery causing an acute exacerbation of chronic insufficiency (Addison's, Hypopituitarism)
• adrenal haemorrhage eg Waterhouse-Friderichsen syndrome (fulminant meningococcemia)
• steroid withdrawal

PC

• Reduced consciousness
• severe fatigue
• abdominal pain
• nausea and vomitting
• Patients can be very unwell

Examination:

• Hypotension

Investigations

Do not wait to perform investigations and establish a definitive diagnosis before treating someone with suspected Addisonian Crisis as this is life threatening and they need immediate treatment.