Acute Adrenal Insufficiency / Crisis

# Acute Adrenal Insufficiency (Adrenal Crisis)
Patient with*** history of adrenal insufficiency who presents with lethargy, fever, nausea, nonspecific abdominal pain, and hypotension concerning for adrenal crisis. Common etiologies include autoimmune, infectious, infarction, and medication inadherence.
Dx
- CBC, CMP, cortisol, ACTH, aldosterone, renin, TSH, lactate
- CXR, BCx x2, UA, Utox
- Evaluate fever, abdominal pain, hypotension per clinical scenario
Tx
- Hydrocortisone 100mg IV x1, then 50mg IV q6h (following lab draws)
- Consider empiric antibiotics and fluids if concerned for sepsis