What are adrenal disorders?
The adrenal glands are two triangle-shaped endocrine glands that sits on top of each kidney. The adrenal glands produce several hormones that are involved in controlling your blood pressure, metabolism and your body’s response to stress.
The most common adrenal disorder is adrenal insufficiency is a condition in which the body is unable to produce normal amounts of the hormone cortisol and, in some cases, aldosterone. This usually happens due to damage to the adrenal glands and is also known as Addison’s disease. Adrenal insufficiency can also happen when the pituitary gland fails to produce ACTH, which is the hormone that controls the adrenal gland.
Common causes of adrenal insufficiency are:
- Congenital adrenal hyperplasia
- Adrenal suppression secondary to long-term steroid therapy (e.g. prednisone, dexamethasone)
- Autoimmune adrenalitis
- ACTH deficiency
Adrenal insufficiency is treated with cortisol replacement therapy given as a tablet on a daily basis, usually 2 to 3 times a day. Patients who are unable to make aldosterone are also placed on aldosterone replacement which is given as a pill daily.
During an illness, such as an infection, the child may develop “adrenal crisis." Adrenal crisis usually starts with vomiting and may quickly progress to a severe illness associated with a very low blood pressure, low blood sugar, a salt/water imbalance, lethargy and shock. Early detection and management as per the “adrenal crisis management plan” can help to prevent an episode of adrenal crisis.
For health professionals
Acute management of adrenal insufficiency
Please refer to RCH clinical practice guidelines for emergency and perioperative management:
Adrenal crisis and acute adrenal insufficiency
Adrenal insufficiency and steroid replacement before and after surgery or procedure requiring GA
Please use the following templates to create sick day management plans and school management plans for patients with primary adrenal insufficiency:
Adrenal insufficiency management plan
Adrenal insufficiency school management plan
Adrenal insufficiency school emergency action plan
Management of adrenal suppression
Please see the following Guideline for management of adrenal suppression secondary to exogenous glucocorticoids
Please use the following templates to create sick day management plans and school management plans for patients with adrenal suppression due to exogenous glucocorticoids:
Adrenal suppression crisis action plan
Adrenal suppression school management plan
For patients and families
Adrenal crisis prevention
School Management Plans
Information specific to Congenital adrenal hyperplasia: