TY - CHAP M1 - Book, Section TI - Adrenal Insufficiency A1 - Furtado, Nicholas A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. A2 - Schafermeyer, Robert PY - 2019 T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 5e AB - Adrenal insufficiency (AI) results from deficiency of glucocorticoid (cortisol), mineralocorticoid (aldosterone), and adrenal androgens (DHEA) secreted by the adrenal cortex.Especially in children, glucocorticoid deficiency impairs glucose metabolism, resulting in fasting hypoglycemia.Aldosterone deficiency leads to hyponatremia, hyperkalemia, hypovolemia, acidosis, and prerenal azotemia.The most common causes of AI are withdrawal of exogenous steroid administration and in infants, congenital adrenal hyperplasia (CAH).Symptoms of AI are usually nonspecific, such as fatigue, anorexia, abdominal pain, nausea, or diarrhea, but it can present as cardiovascular collapse or shock, and hence a high index of suspicion is required.Acute management consists of rapid fluid resuscitation, correction of hypoglycemia, hyperkalemia, and acidosis, and parenteral (IV/IO) stress doses of hydrocortisone. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1155427796 ER -