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CPE-008 · Safety
AI-13: Known adrenal insufficiency with intercurrent illness
Known adrenal insufficiency with intercurrent illness. Evaluates known adrenal insufficiency.
Active rulePriority 2Adrenal engine v1.0.0
Condition
- known adrenal insufficiency
- fever, vomiting, diarrhea, trauma or surgery
What it reports
- Sick-day rules apply: glucocorticoid cover is increased per the patient's plan, and parenteral treatment is needed if vomiting
Diagnostic boundary
- Dose and route belong to the treating physician and the patient's written plan.
Evidence
- EV-ES-PAI-2016Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(2):364-389.Supports: Morning cortisol and ACTH as first tests; ACTH stimulation with 250 µg cosyntropin; peak cortisol below 18 µg/dL as insufficient Suspected adrenal crisis must be treated without waiting for tests
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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