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Symptome wie allgemeine Schw\u00e4che, \u00dcbelkeit\/Erbrechen, M\u00fcdigkeit, Hyponatri\u00e4mie, Hyperkali\u00e4mie, Hypoglyk\u00e4mie sowie ausgepr\u00e4gte Hypotonie bis zum Schock k\u00f6nnen in der Diagnosestellung einer Nebennierenrindenkrise wegweisend sein. Die Grunderkrankung der NNRI ist ebenso von nicht immer eindeutigen Symptomen gepr\u00e4gt und je nach prim\u00e4rer oder sekund\u00e4rer Form unterschiedlich ausgepr\u00e4gt.<\/jats:p><jats:p>Nach der Diagnosestellung sind die Patientenschulung, die richtige Dosierung der Substitutionsmedikation und die Adh\u00e4renz der Patienten entscheidend f\u00fcr den weiteren Verlauf, insbesondere f\u00fcr die Vermeidung einer Nebennierenkrise. Diese stellt eine Ursache der erh\u00f6hten Mortalit\u00e4t betroffener Patienten dar, was in der aktuellen Literatur h\u00e4ufig beschrieben ist. Jedoch zeigt sich in der Literaturrecherche, dass der Verlauf solcher Krisen bzw. die Kausalit\u00e4t von letalen Verl\u00e4ufen selten thematisiert wird, obwohl das Wissen um die Erkrankung und ein damit verbundenes, rasches Handeln v.\u202fa. f\u00fcr in der Notaufnahme und auf der Intensivstation t\u00e4tige \u00c4rzte von gro\u00dfer Bedeutung sind.<\/jats:p><jats:p>Berichtet wird \u00fcber eine Patientin, die bei bekannter sekund\u00e4rer NNRI das Vollbild einer Nebennierenkrise entwickelte. Trotz rascher Diagnosestellung sowie Therapieeinleitung war infolge von prolongierter Hypoxie und Hypoglyk\u00e4mie ein massiver Hirnschaden unabwendbar. Der Fallbericht zeigt die m\u00f6gliche Symptomatik, v.\u202fa. eine massive Hypoglyk\u00e4mie und einen initial katecholaminrefrakt\u00e4ren Schock. Au\u00dferdem zeigt er die Schwere des Krankheitsbildes und stellt die Bedeutung einer schnellen Therapie trotz erschwerter Diagnosestellung dar.<\/jats:p>","DOI":"10.1007\/s00101-022-01088-w","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T12:04:10Z","timestamp":1646049850000},"page":"462-466","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypoxisch-hypoglyk\u00e4mischer Hirnschaden infolge einer Nebennierenrindenkrise\u00a0\u2013 eine wichtige Differenzialdiagnose bei unspezifischer Symptomatik"],"prefix":"10.1007","volume":"71","author":[{"given":"C.","family":"Mayer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Hackenbroch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Helm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,2,28]]},"reference":[{"key":"1088_CR1","first-page":"882","volume":"110","author":"M Quinkler","year":"2013","unstructured":"Quinkler\u00a0M, Beuschlein\u00a0F, Hahner\u00a0S, Meyer\u00a0G, Schofl\u00a0C, Stalla\u00a0GK (2013) Adrenal cortical insufficiency\u2014a life threatening illness with multiple etiologies. 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