Management of adrenal crisis

Adrenal crisis (AC) is a life-threatening emergency that may occur in patients with chronic adrenal insufficiency (AI). Due to the rarity of AI, physicians are often unfamiliar with the correct emergency treatment of AC. However, objective data supporting this assumption are lacking.

Hahner et al. conducted a prospective study to assess the current management of AC with a special focus on the time needed for initiation of parenteral glucocorticoid treatment in a well characterised cohort of patients with chronic AI and compared the results with expert opinion on optimal time targets and time limits in AC.

Their data demonstrates that patient care in AC needs to be improved, particularly, the time from arrival of emergency health professionals until administration of parenteral glucocorticoids was unacceptably long. They suggest that improved education of emergency physicians and promotion of self-injection of hydrocortisone by patients or their relatives are key elements to eliminate death from AC in patients with known chronic AI.

Read full article by Hahner et al., titled ‘Timelines in the management of adrenal crisis – targets, limits and reality’ Clinical Endocrinology 82 497-502. DOI: 10.1111/cen.12609