Update on adrenal crisis

Adrenal crisis is a life-threatening condition which is caused by an insufficient level of glucocorticoids in the body. Most patients have preexisting adrenal insufficiency, and physical or emotional stress triggers the adrenal crisis. This includes acute illness and surgery. It is important that patients receive a life-saving emergency injection of 100 mg hydrocortisone immediately and a continuous supplementation afterwards. This article focuses on the pathophysiology, trigger factors, prevention and emergency treatment of adrenal crisis in adult patients. By adjusting the regular dosage of glucocorticoids in stressful situations, adrenal crisis can be prevented. Patients at risk for adrenal crisis should keep an emergency injection kit and a standardised European emergency card and receive life-saving doses of glucocorticoids in emergency situations as quickly as possible. • Overview on the pathophysiology of adrenal crisis • Preventing adrenal crisis in stressful situations including perioperative settings • Emergency management of adrenal crisis