Critical illness-related corticosteroid insufficiency Microchapters Home Overview Historical Perspective Pathophysiology Causes Differentiating Critical illness-related corticosteroid insufficiency from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and Prognosis Diagnosis History and Symptoms Physical Examination Laboratory Findings MRI Ultrasound Other Imaging Findings Other Diagnostic Studies Treatment Medical Therapy Surgery Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Critical illness-related corticosteroid insufficiency history and symptoms On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images American Roentgen Ray Society Images of Critical illness-related corticosteroid insufficiency history and symptoms All Images X-rays Echo & Ultrasound CT Images MRI Ongoing Trials at Clinical Trials.gov US National Guidelines Clearinghouse NICE Guidance FDA on Critical illness-related corticosteroid insufficiency history and symptoms CDC on Critical illness-related corticosteroid insufficiency history and symptoms Critical illness-related corticosteroid insufficiency history and symptoms in the news Blogs on Critical illness-related corticosteroid insufficiency history and symptoms Directions to Hospitals Treating Critical illness-related corticosteroid insufficiency Risk calculators and risk factors for Critical illness-related corticosteroid insufficiency history and symptoms Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ## Overview[edit | edit source] ## History[edit | edit source] ## Symptoms[edit | edit source] The best known feature that suggests a possible underlying adrenal insufficiency is low blood pressure despite resuscitation with intravenous fluids, requiring vasopressor drugs. These patients typically display tachycardia and other signs of hyperdynamic shock. Other symptoms include fever, purpura fulminans, and gastrointestinal or neurological disturbances. All these features are relatively non-specific in intensive care patients. In some patients a specific reason for adrenal insufficiency can be suspected, such as prior intake of corticosteroids that suppressed the HPA axis, or use of enzyme inducing drugs such as phenytoin. Treatment with imidazole drugs such as etomidate, ketoconazole and miconazole can also suppress the HPA axis, as well as drugs used specifically for this purpose, such as metyrapone.Lamberts SW, Bons EG, Bruining HA, de Jong FH (1987). "Differential effects of the imidazole derivatives etomidate, ketoconazole and miconazole and of metyrapone on the secretion of cortisol and its precursors by human adrenocortical cells". J. Pharmacol. Exp. Ther. 240 (1): 259–64. PMID 3027305. Unknown parameter `|month=` ignored (help)CS1 maint: Multiple names: authors list (link) ## References[edit | edit source] Template:WH Template:WS