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Adrenal Suppression

Signs & Symptoms

 High corticosteroid doses
Ref: Epocrates [ History & Exam]
Glucocorticoid use
Ref: Epocrates [ History & Exam]
Suddenly stopped glucocorticoid treatment
Ref: Epocrates [ History & Exam]
Weight loss
Ref: Epocrates [ History & Exam]

Physical Examination

 Dorsocervical fat pad
Note: due to Supraphysiologic doses of oral glucocorticoids
Ref: Epocrates [ History & Exam]
Facial plethora
Note: due to Supraphysiologic doses of oral glucocorticoids
Ref: Epocrates [ History & Exam]
Orthostatic hypotension
Ref: Epocrates [ History & Exam]

Lab / Serology

 Abnormal overnight Metyrapone test
Note: 11-deoxycortisol <7 micrograms/dL in Metyrapone test
Ref: Epocrates [ Tests]
Low Serum cortisol
Note: Serum cortisol <18 micrograms/dL with glucose <40 mg/dL
Ref: Epocrates [ Tests]
Low Serum cortisol in Insulin tolerance test
Ref: Epocrates [ Tests]

Imagin Study

Complication

 Hypotension
Note: due to Adrenal crisis
Ref: Epocrates [ History & Exam]
Hypovolemic shock
Note: due to Adrenal crisis
Ref: Epocrates [ History & Exam]
Postural dizziness
Note: due to Adrenal crisis
Ref: Epocrates [ History & Exam]

Risk Factors

Cause

Other