Early identification,diagnosis and treatment of adrenal crisis during pregnancy

doi:10.3877/cma.j.issn.2095-3259.2018.02.008

Abstract

Abstract:

Although the incidence of adrenal crisis in pregnancy is low, but without timely diagnosis and treatment, it may lead to maternal and fetal mortality. The diagnosis of adrenal crisis in pregnancy is very difficult, because the symptoms of adrenal crisis are similar to physiological changes in pregnancy, such as pregnancy nausea, vomiting, fatigue and cyasma. This article discusses the early identification, diagnosis and treatment of adrenal crisis in pregnancy.

Key words: Adrenal gland diseases, Adrenal cortex diseases, Pregnancy, high-risk

Lin Gao, Minxiang Lei. Early identification,diagnosis and treatment of adrenal crisis during pregnancy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2018, 07(02): 95-99.

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References 27

[1]	Smans LC, Van der Valk ES, Hermus AR, et al. Incidence of adrenal crisis in patients with adrenal insufficiency [J]. Clinical Endocrinology, 2016, 84(1): 17-22.
[2]	Hahner S, Mbleicken L. Epidemiology of adrenal crisis in chronic adrenal insufficiency: the need for new prevention strategies [J]. European Journal of Endocrinology, 2010, 162(3): 597-602.
[3]	Organization WH. ICD-10. International Statistical Classification of Diseases and Related Health Problems [J]. Acta Chirurgica Iugoslavica, 2009, 56(3): 65-69.
[4]	Allolio B. Extensive expertise in endocrinology. Adrenal crisis[J]. Eur J Endocrind, 2015, 172(3):115-124.
[5]	Anand G, Beuschlein F. MANAGEMENT OF ENDOCRINE DISEASE: Fertility, pregnancy and lactation in women with adrenal insufficiency [J]. Eur J Endocrinol, 2018, 178(2):R45-R53.
[6]	Esteban NV, Loughlin T, Yergey AL, et al. Daily cortisol production rate in man determined by stable isotope dilution/mass spectrometry [J]. J Clin Endocrinol Metab, 1991, 72(1): 39-45.
[7]	Lamberts SW, Bruining HA, de Jong FH. Corticosteroid therapy in severe illness [J]. N Engl J Med, 1997, 337(18): 1285-1292.
[8]	Bergthorsdottir R, Leonssonzachrisson M, Oden A, et al. Premature mortality in patients with Addison′s disease: a population-based study [J]. J Clin Endocrinol Metab, 2006, 91(12): 4849-4853.
[9]	Seravalli L. Predisposing factors for adrenal insufficiency [J]. N Engl J Med, 2009, 361(8):824-825.
[10]	Grossmann M, Topliss DJ. A cool case: hypothermia and adrenal failure [J]. Lancet, 2006, 368(9553): 2184.
[11]	杨义生，罗邦尧. 肾上腺危象[J]. 国际内分泌代谢杂志，2005, 25(3): 214-215.
[12]	Mastorakos G, Ilias I. Maternal and fetal hypothalamic-pituitary-adrenal axes during pregnancy and postpartum [J]. Ann N Y Acad Sci, 2010, 997(1):136-149.
[13]	White K, Arlt W. Adrenal crisis in treated Addison′s disease: a predictable but under-managed event [J]. European Journal of Endocrinology, 2010, 162(1): 115.
[14]	Hahner S, Spinnler C, Fassnacht M, et al. High incidence of adrenal crisis in educated patients with chronic adrenal insufficiency-a prospective study[J]. J Clin Endocrinol Metab, 2015, 100(2): 407-416.
[15]	Bouillon R. Acute Adrenal Insufficiency [J]. Endocrinology and Metabolism Clinics, 2016, 35(4): 767-775.
[16]	Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline [J]. J Clin Endocrinol Metab, 2016, 101(2): 364-389.
[17]	Lebbe M, Arlt W. What is the best diagnostic and therapeutic management strategy for an Addison patient during pregnancy？[J]. Clinical Endocrinology, 2013, 78(4): 497-502.
[18]	Nolten WE, Lindheimer MD, Rueckert PA, et al. Diurnal Patterns and Regulation of Cortisol Secretion in Pregnancy [J]. J Clin Endocrinol Metab, 1980, 51(3): 466-472.
[19]	Bouillon R. Acute adrenal insufficiency [J]. 2006, 35(4): 767-775.
[20]	Meeking S. Treatment of Acute Adrenal Insufficiency [J]. Clinical Techniques in Small Animal Practice, 2007, 22(1): 36-39.
[21]	Husebye ES, Allolio B, Arlt W, et al. Consensus statement on the diagnosis, treatment and follow-up of patients with primary adrenal insufficiency[J]. J Intern Med, 2014, 275(2): 104-115.
[22]	Jung C, Inder WJ. Management of adrenal insufficiency during the stress of medical illness and surgery [J]. Med J Aust, 2008, 188(7): 409-413.
[23]	Brent F. Addison′s disease and pregnancy [J]. Am J Surg, 1950, 79(5): 645-652.
[24]	Lekarev O, New MI. Adrenal disease in pregnancy [J]. Best Pract Res Clin Endocrinol Metab, 2011, 25(6): 959-973.
[25]	Hahner S, Allolio B. Management of adrenal insufficiency [J]. Expert Opin Pharmacother, 2015, 6(14): 2407-2417.
[26]	Jung C, Inder WJ. Management of adrenal insufficiency during the stress of medical illness and surgery [J]. Med J Aust, 2008, 188(7): 409-413.
[27]	Arlt W. The approach to the adult with newly diagnosed adrenal insufficiency [J]. J Clin Endocrinol Metab, 2009, 94(4): 1059-1067.

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