What does a severe acute adrenal insufficiency presentation typically include?

Severe acute adrenal insufficiency can lead to various serious clinical manifestations due to a critical lack of adrenal hormones, primarily cortisol. One of the hallmark signs of this condition is hypotension, which can progress to shock. This occurs because cortisol plays a crucial role in maintaining blood pressure and vascular responsiveness. In situations of severe adrenal insufficiency, the body is unable to mount an appropriate stress response, resulting in hypovolemia and inadequate perfusion, leading to low blood pressure.

In addition to hypotension, patients may exhibit additional symptoms like fatigue, weakness, and abdominal pain, but the presence of hypotension is particularly significant as it indicates a life-threatening condition requiring immediate medical intervention. Recognizing hypotension and shock as manifestations of severe acute adrenal insufficiency is critical for timely treatment, which often involves administering glucocorticoids along with fluid resuscitation to stabilize the patient's condition.