In children, weight loss with failure to thrive can be seen frequently, while other manifestations can include hypoglycemic crises with seizures. The most common clinical manifestations of adrenal crisis include: weakness, severe fatigue, unintentional weight loss, nausea, vomiting, abdominal pain, decreased appetite, back or limb pain, dizziness, somnolence, confusion, and loss of consciousness. Here we will be using the definition suggested by Rushworth, et al 2019: Multiple expert reviews have tried to formulate their definitions of adrenal crisis.

There is no consensus regarding the definition of an adrenal crisis. Educating patients and their families about sick day rules and the availability of intramuscular hydrocortisone at home are essential in preventing adrenal crisis. While this disease is well described, it is often difficult to recognize, and treatment initiation may be delayed leading to increased morbidity and mortality. The clinicians should differentiate between adrenal insufficiency and adrenal crisis since the adrenal crisis is fatal if left untreated. Early identification and prompt management can save the patient's life and impact survival. It is an endocrine emergency precipitated by an internal or external process in the setting of a lack of production of the adrenal hormone cortisol, which is the primary glucocorticoid. Patients may deteriorate quickly, resulting in death at home or soon upon arrival in the hospital. Adrenal crisis (also known as Addisonian crisis), also termed acute adrenal insufficiency is an acute life-threatening condition with a mortality rate of 0.5/100 patient-years and remains a significant cause of death in patients with adrenal insufficiency.

Definition of adrenal