Abstract
Acute adrenal insufficiency is a rare but lethal event. Its symptoms are not specific, and therefore its diagnosis is frequently difficult. We report a 78-year-old man who presented with shock after a surgical procedure performed two months previously. In spite of adequate fluid resuscitation, catecholamine use, and glucose infusion, the patient's symptoms, which included hypotension, bradycardia, and hypoglycemia, persisted. Hence, we suspected acute adrenal insufficiency and administered hydrocortisone intravenously for the purpose of treatment and diagnosis. Subsequently, the patient exhibited a rapid improvement and recovery. We have described a case of acute adrenal insufficiency that manifested as hypotension, bradycardia, resistance to catecholamine use, and hypoglycemia after a surgical procedure performed two months previously. Since adrenal crisis is a life-threatening state, in cases of catecholamine-resistant cardiac insufficiency and refractory hypoglycemia, physicians should consider the possibility of an adrenal crisis and rapidly initiate steroid therapy.
