27th May 2025

Complications

Long-term PAI can result in acute adrenal crisis with hypovolaemic shock, hypoglycaemia, and electrolyte abnormalities as described above. However it is preventable with good education and dose adjustment during intercurrent illness.

Other complications are related to excessive glucocorticoid replacement, resulting in secondary Cushing’s syndrome, osteoporosis and hypertension. Cushing’s syndrome manifests as weight gain, moon facies and peripheral muscle wasting.