Acute adrenal insufficiency

Etiology

Primary adrenal insufficiency (Addison’s disease)

• Autoimmune
• Surgical removal or trauma
• Infection, e.g., tuberculosis, histoplasmosis
• Adrenal hemorrhage
• Metastatic cancer
• Adrenoleukodystrophy
• Hemochromatosis or amyloidosis
• Congenital adrenal hyperplasia

Secondary adrenal insufficiency

• Pituitary failure (atrophy, necrosis, tumor)
• Exogenous steroids

DDx

• Other types of shock, e.g., septic, cardiogenic, hypovolemic, anaphylactic
• Hyperkalemia due to other causes, e.g., renal failure, rhabdomyolysis
• Hyponatremia due to other causes, e.g., SIADH, cirrhosis, vomiting
• Abdominal pain due to other causes

See related DDx

• Hypotension or shock
• Hyperkalemia
• Hyponatremia
• Abdominal pain
• Chronic adrenal insufficiency