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Acute Adrenal Insufficiency in the Perioperative Period

A Case Report

Karamchandani, Kunal, MD, FCCP; Leathem, Jarrett, DO; Sinz, Elizabeth H., MD, MEd, FCCM, FSSH

doi: 10.1213/XAA.0000000000000846
Case Reports

Acute adrenal insufficiency is a rare but potentially life-threatening event during the perioperative period. The usual manifestations of an acute adrenal crisis can mimic common postoperative complications and a high index of suspicion is required for the diagnosis. Early diagnosis and prompt treatment can be lifesaving. We present the case of a 65-year-old man who, after a partial nephrectomy, developed acute adrenal insufficiency, which remained undiagnosed in the postoperative period, eventually leading to cardiac arrest. This case highlights the need for perioperative physicians to have a watchful eye for diagnosing and treating this uncommon yet lethal condition.

From the Department of Anesthesiology & Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Accepted for publication June 6, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Kunal Karamchandani, MD, FCCP, Department of Anesthesiology & Perioperative Medicine, H187, Penn State Health Milton S. Hershey Medical Center, 500 University Dr, Hershey, PA 17033. Address e-mail to

© 2019 International Anesthesia Research Society
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