Salt-losers
In salt-losers, the enzyme deficiency in the adrenal glands is more severe than in the salt-losers. Their strong tendency to lose excessive amounts of salt in the urine, if uncontrolled, can cause acute dehydration, very low blood pressure, nausea and vomiting. The levels of salt (sodium and chloride) and sugar (glucose) in the blood fall, and the potassium level rises. This dangerous situation is referred to as an ‘adrenal crisis’. Very urgent medical treatment is needed as a life-saving measure.
Some patients with the salt-losing form of CAH receive very little warning of adrenal crises. Repetitive vomiting is often the first sign. Drowsiness is most likely to be due to an abnormally low blood sugar levels and if sugar is not given, may progress to loss of consciousness....
What causes an adrenal crisis?
The body usually responds to sickness (fever, infection or other illness) and physical injury by releasing more cortisol. This helps to boost the blood sugar and blood pressure, aiding recovery. In CAH, the adrenal glands are unable to make more cortisol. Therefore the body is less protected, and the effects of illness or injury may be more severe. Adrenal crises can be readily prevented (see the following section on Treatment of CAH).