Addison crisis

An Addison crisis occurs when the body needs more cortisol than it has available in the situation. This is usually the case in stressful situations. These include severe physical stress, but also febrile infections, gastrointestinal infections or operations.

Similarly, severe psychological stress, trauma or the sudden discontinuation of cortisol therapy can lead to such a crisis. An adrenal infarction also results in a loss of adrenal function and a hormone deficiency. The Addison crisis is an acutely life-threatening situation in which the body is not able to react appropriately to a stress situation, resulting in severe circulatory disorders that can lead to coma.

Due to the lack of the hormones produced by the adrenal glands, the regulation of blood pressure is limited. Due to the hormone deficiency, the body loses salts and water, which leads to a drop in blood pressure. Without a quick therapy with cortisol, this can lead to a state of shock, which can lead to coma or in the worst case be fatal. The crisis manifests itself through nausea, vomiting, diarrhea, fever, confusion, hypoglycaemia and the drop in blood pressure leads to palpitations. Often the Addison’s disease crisis is the reason why a suspicion of Addison’s disease is raised.

Secondary adrenal insufficiency

Secondary adrenal insufficiency is a disorder of the so-called pituitary gland. This is part of the human brain and has a stimulating effect on the adrenal gland by releasing certain hormones. These hormones naturally include the messenger substance ACTH (adrenocorticotropic hormone), which is produced in the adenohypophysis or pituitary gland and induces cortisol production in the adrenal gland after release.The pituitary gland sometimes does not work properly and as a result produces insufficient amounts of ACTH.

The cause of the malfunction can be a tumor. Due to the disrupted production, the messenger substances cannot act at their destination and the adrenal cortex has no drive to produce cortisol. Those affected then develop a so-called hypocortisolism, i.e. an insufficient amount of cortisol in the blood or body circulation.