Guidance for the prevention and emergency management of adult patients with adrenal insufficiency

Clinical Medicine : Journal of the Royal College of Physicians of London
Helen L SimpsonWiebke Arlt

Abstract

Adrenal insufficiency (AI) is an often-unrecognised endocrine disorder, which can lead to adrenal crisis and death if not identified and treated. Omission of steroids in patients with AI, particularly during physiological stress such as an intercurrent illness or surgery, can also lead to an adrenal crisis. The National Reporting and Learning System (NRLS) identified 78 incidents including two deaths and six incidents of severe harm to patients in a recent 4-year period. This guidance will go through causes of adrenal insufficiency, groups at risk of an adrenal crisis, emergency management and management for surgical procedures. A new NHS Steroid Emergency Card has been developed to be carried by patients at risk of adrenal crisis. We hope the new emergency card and this guidance will increase awareness of the need to start steroids promptly in patients at risk of an adrenal crisis, particularly those presenting in the emergency department or to acute medicine teams and those undergoing surgery or invasive procedures.

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Citations

Sep 17, 2020·Clinical Medicine : Journal of the Royal College of Physicians of London·Daniel L Morganstein, James Larkin
Jul 18, 2020·Clinical Medicine : Journal of the Royal College of Physicians of London·Anton Emmanuel
Oct 22, 2020·Drug and Therapeutics Bulletin
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Jul 14, 2021·BMJ : British Medical Journal·Alessandro Prete, Irina Bancos
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Addison Disease

Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Discover the latest research on Addison's disease here.

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