The symptoms of adrenal insufficiency usually begin gradually. Symptoms include: low blood pressure that falls further when standing, causing dizziness or fainting skin changes in addison’s disease, with areas of hyperpigmentation, or dark tanning, covering exposed and nonexposed parts of the body; this darkening of the skin is most visible on scars; skin folds; pressure points such as the elbows, knees, knuckles, and toes; lips; and mucous membranes.
In about 25 percent of patients, symptoms first appear during an addisonian crisis.
In patients in acute adrenal crisis, IV access should be established urgently, and an infusion of isotonic sodium chloride solution should be begun to restore volume deficit and correct hypotension. Some patients may require glucose supplementation. The precipitating cause should be sought and corrected where possible.
