Adrenal, addisonichesky crisis or acute adrenal insufficiency cortical zone and an extreme manifestation of severe Addison's disease. Accompanied by a reduction in the functional activity of the adrenal cortex. Such crises occur is very difficult, there are on the back of strong physical or emotional stress and often lead to death.
Causes
The main reason for the formation of adrenal crisis - abrupt cessation of operation of the adrenal cortex, a sharp decline in the level of adrenal hormones in the blood. Usually this occurs in the following cases:
- cases of substitute hormonal therapy in patients suffering from Addison's disease,
- adrenal by trauma or surgery,
- acute generalized infections and sepsis with necrosis of the adrenal cortex,
- with hemorrhages in the adrenal cortex,
- in severe blood loss or burn disease.
As a result of all these reasons, there is a critical decrease in the amount of hormones produced by the adrenal cortex. The result is a loss of fluid and dehydration with simultaneous loss of potassium, disruption of the cardiac muscle and other muscles of the body. It suffers carbohydrate metabolism, leading to kidney failure. In a short time a person can fall into a coma.
Symptoms of adrenal crisis
Adrenal crisis may develop within a few hours, sometimes a few days. Initially manifested muscle pain and severe fatigue, appetite is disturbed. The signs of the coming crisis are:
- a sharp reduction in pressure,
- arrhythmia, A sense of disruption of the heart,
- severe sweating,
- limb cooling, chills,
- severe weakness with inability to stand on his feet,
- diarrhea, nausea and vomiting,
- sudden and severe abdominal pain,
- a sharp reduction in the amount of urine,
- difficulty in speech, fainting, hallucinations,
- development of coma.
When such symptoms need urgent hospitalization in the intensive care unit with the introduction of a whole range of drugs.
Diagnostics
When adrenal Stroke urgent blood test, which is edgy and leukocytosis, accelerated erythrocyte sedimentation rate, a sharp rise erythrocytes. Wherein blood glucose levels sharply lower than the norm. Sharply reduced amounts of electrolytes - sodium, potassium and chlorine, reduced creatinine. Urine analysis revealed acetone, protein and erythrocytes.
In the analysis of blood hormone levels shows sharp declines in the level of hormones of the adrenal cortex - corticosteroids. In carrying out the ECG revealed a violation of cardiac conduction.
Treatment of adrenal crisis
Treatment of adrenal crisis is conducted in the intensive care unit - the therapy corticosteroids with individual selection of doses and held drip electrolyte and glucose solutions. Held antishock therapy.
- It shows the urgent hospitalization.
- Intravenously administered 0.9% sodium chloride solution to eliminate dehydration hydrocortisone. Clinical improvement (estimated primarily on restoring blood pressure) usually occurs within 4-6 hours after intravenous therapy.
- As the temperature increases (compared to normal blood pressure) designate antipyretics such as acetaminophen.
- When surgery is necessary to adjust the dose of steroid hormones.
- Prevention of infectious diseases.
Forecast
Usually after adrenal crisis is necessary for life to be on hormone replacement therapy, because the adrenal glands can no longer operate as before, they are irreversibly damaged.
Patient life will be registered by an endocrinologist, will be continuously adjustment of doses of drugs.
