# Addisonian Crisis in a 39-Year-Old Woman With Primary Adrenal Insufficiency

## TL;DR

A 39-year-old woman with Addison’s disease experienced a life-threatening adrenal crisis due to vomiting from a stomach virus, requiring intensive care treatment.

## Contribution

This case emphasizes the need for early recognition and proper management of adrenal crises in patients with Addison’s disease.

## Key findings

- The crisis was likely triggered by vomiting from viral gastroenteritis, preventing oral medication.
- The patient was successfully treated with intravenous fluids, pressors, and stress-dose steroids.
- The case underscores the importance of patient education to prevent future adrenal crises.

## Abstract

Primary adrenal insufficiency, or Addison’s disease, is a rare endocrine disorder characterized by inadequate cortisol and aldosterone production. Addisonian crisis is a life-threatening complication triggered by physiological stress, infection, or medication non-adherence. We present the case of a 39-year-old Caucasian woman with a history of Addison’s disease, Hashimoto’s thyroiditis, celiac disease, vitiligo, and alopecia areata who presented with hypotension, bradycardia, and nausea secondary to an Addisonian crisis, likely precipitated by cyclic nausea and vomiting due to viral gastroenteritis, leading to an inability to tolerate oral medication. She was managed with intravenous fluids, pressors, and stress-dose steroids in the intensive care unit (ICU), with subsequent stabilization and transition to oral therapy. This case highlights the importance of early recognition, aggressive management, and patient education to prevent recurrent adrenal crises.