===== Adrenal Crisis =====

===common causes:===
  * addison's disease
  * chronic steroid use
  * Waterhouse-Friedrichson syndrome (adrenal infarction due to DIC)
  * Pituitary apoplexy (pit infarction esp post partum, DIC)
  * Oncology - checkpoint inhib immunotherapy
  * Look for precipitants: -infection, trauma, pregnancy, reduced steroid use. Initiation of carbamazepine, etomidate, phenytoin etc

===presentation:===
  * Vasodilatory shock esp refractory to fluid
  * N,V, abdo pain, fever, delirium

===Investigations:===
  * low Na+, high K+, low Glu

**NB - It is a Dx of exclusion. Rapid response to steroid is supportive of Dx

===Management:===
  * look for triggers and treat
  * hydrocortisone esp if known adrenal insufficiency
  * dexamethasone - ??? esp if not known insufficiency - check
  * supportive