Date Published

February 4, 2020

Updated For

ALS PCS Version ALS PCS Version 5.2


With respect to the Suspected Adrenal Crisis Medical Directive from the ALS PCS, I'm wondering what specific medical conditions would fall under this umbrella because the only one I am familiar with is Addison's?


The condition in the ALS-PCS states "A patient with primary adrenal failure who is experiencing clinical signs of adrenal crisis". Primary adrenal failure is synonymous with Addison's. Primary adrenal failure/Addison's can be more than just the autoimmune kind (although, this is the most common and generally when people say they have Addisons, this is what they mean.

For more information/a deeper dive on Adrenal insufficiency.

The differentiation of adrenal failure is: Primary (adrenal failure due to the adrenal glands themselves) Secondary (adrenal failure due to inappropriate signaling from the pituitary gland telling the adrenal glands not to work). Tertiary (inappropriate signaling to the pituitary, which then inappropriately signals the adrenal glands)

The DDx of Primary Adrenal Failure (Addisons) is:

  • Autoimmune cause
  • Infectious destruction (TB, HIV, fungal causes, quaternary syphilis)
  • Cancer (bilateral adrenal destruction)
  • Drug-induced adrenal destruction
  • Genetic forms



Keywords are not available for this question at this time.

Additional Resources

No additional resources are available for this SWORBHP Tip.