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Endocrine Emergencies

Recognition and emergency management of life-threatening endocrine crises.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Endocrine Emergencies?

Endocrine emergencies are life-threatening acute decompensations of hormonal disorders. Diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), thyroid storm, myxedema coma, adrenal crisis, and hypercalcemic crisis are the main endocrine emergencies.

DKA is characterized by ketosis due to insulin deficiency in type 1 diabetes, while HHS is characterized by extreme hyperglycemia and dehydration in type 2 diabetes. In DKA, pH drops and anion gap increases; in HHS, osmolality is markedly elevated (>320 mOsm/kg).

Myxedema coma is the emergency decompensation of severe hypothyroidism; it presents with hypothermia, hypotension, bradycardia, and loss of consciousness. In all endocrine emergencies, early diagnosis and prompt intervention determine survival.

Symptoms

DKA: Vomiting, abdominal pain, Kussmaul respiration, altered consciousness
HHS: Severe dehydration, confusion, seizures
Thyroid storm: High fever, tachycardia, agitation
Adrenal crisis: Hypotension, shock, hypoglycemia
Myxedema coma: Hypothermia, bradycardia, loss of consciousness
Hypercalcemic crisis: Confusion, oliguria, cardiac arrhythmia

Risk Factors

Untreated or inadequately treated endocrine disease
Medication non-adherence or sudden discontinuation of treatment
Infection, surgery, trauma (triggering stress)
Known diabetes, thyroid, or adrenal disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If any of the above emergency findings develop → EMERGENCY ROOM
  • If acute deterioration in known endocrine patient
  • If altered consciousness and hemodynamic instability are present
  • If unexplained severe metabolic disorder is detected

Treatment Methods

01
DKA: IV insulin infusion + fluids + potassium replacement
02
HHS: Aggressive fluid resuscitation + insulin (low dose)
03
Thyroid storm: PTU + iodine + propranolol + hydrocortisone
04
Adrenal crisis: IV hydrocortisone 100 mg + fluids
05
Myxedema coma: IV levothyroxine + IV hydrocortisone + supportive care
06
Hypercalcemic crisis: IV isotonic saline + calcitonin + zoledronic acid

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.