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An adrenal crisis happens during times of physical stress, when the body cannot make enough of the adrenal hormones cortisol and aldosterone. Hormones are chemicals made by the body to do certain jobs including to control blood sugar levels, blood pressure, blood volume and the amount of salt in the blood. Many adrenal crises can be prevented. If not treated, adrenal crisis can be life threatening.
Children who have congenital adrenal hyperplasia (CAH), hypopituitarism or are on long term steroid medicine may sometimes have an adrenal crisis. On rare occasions, children without one of these conditions may also experience an adrenal crisis.
All of the above events are physical stresses that can cause an adrenal crisis in children with certain conditions, or in children on long term steroid medicine.
Children with adrenal crisis may:
Adrenal crisis can often be prevented by early treatment - please make sure you discuss the information below with your child's endocrinologist so that you understand it well. If your child has congenital adrenal hyperplasia (CAH), hypopituitarism or is on long term steroid medicine you need to watch out for the following common illnesses that may lead to an adrenal crisis.
One or two vomits
More than two vomits
If your child has any diarrhoea they must see your family doctor (GP) or the closest hospital emergency department to get an injection of hydrocortisone. Your child will need to be monitored for several hours after this injection.
Give three times the normal dose of cortisone, prednisolone or hydrocortisone. They must see your family doctor (GP) or closest hospital emergency department to be assessed and will need to keep taking three times the usual dose of steroids until they are well again. If your child is on Florinef, continue giving the normal dose of this medicine.
Your child must see your family doctor (GP) or closest hospital emergency department to get an injection of hydrocortisone. They will need to be monitored for several hours after this injection.
An injection of hydrocortisone is given to your child before the operation and either an injection or increased does of tablets is given after the operation. Please make sure you always tell the medical staff caring for your child if your child has congenital adrenal hyperplasia (CAH), hypopituitarism or is on long term steroid medicine.
Routine follow up with your endocrine doctor as usual or as directed by your family doctor.
Your child's endocrinologist name:
Family doctor name:
Developed with the RCH Dept of Endocrinology. First published Nov 2006. Updated September 2012.