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Adrenal Emergencies in Critically Ill Cancer Patients

  • Ryan P. Richard
  • Julie A. Grishaw
  • Kyle B. EnfieldEmail author
Reference work entry

Abstract

The presentation of an adrenal emergency to critical care providers may range from manifestations resulting from the underproduction of cortisol leading to shock in cases of adrenal crisis, to poorly controlled hypertension through over production of catecholamines in cases of pheochromocytoma. The diversity of presentations underscores the critical role of the adrenal glands in maintaining homeostasis. While pheochromocytoma represents a rare primary malignancy, adrenal insufficiency is more typically the result of treatment of complications related to other primary malignancies. In the case of adrenal insufficiency, the provider must replace hormone while at the same time work to distinguish between multiple etiologies. Importantly, the provider should recognize the mechanisms by which medications prescribed to treat malignancy may have side effects causing adrenal insufficiency. In pheochromocytoma, control of malignant hypertension is important while also determining the underlying cause. In both cases the prognosis is determined, like in most areas of medicine, by the etiology. In most cases, with supportive care, the prognosis is favorable.

Keywords

Adrenal insufficiency Primary adrenal insufficiency Secondary adrenal insufficiency Tertiary adrenal insufficiency Critical illness-related cortisol insufficiency Autoimmune adrenalitis Pheochromocytoma 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Ryan P. Richard
    • 1
  • Julie A. Grishaw
    • 1
  • Kyle B. Enfield
    • 2
    Email author
  1. 1.University of VirginiaCharlottesvilleUSA
  2. 2.Division of Critical Care and Pulmonary Medicine, Department of MedicineUniversity of VirginiaCharlottesvilleUSA

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