RT Book, Section A1 Furtado, Nicholas A2 Tenenbein, Milton A2 Macias, Charles G. A2 Sharieff, Ghazala Q. A2 Yamamoto, Loren G. A2 Schafermeyer, Robert SR Print(0) ID 1155427796 T1 Adrenal Insufficiency T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 5e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259860751 LK accesspediatrics.mhmedical.com/content.aspx?aid=1155427796 RD 2024/03/29 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.