What is the most important next step in management to prevent further crises?

A 34-year-old woman with Addison’s disease reported four adrenal crises over the preceding 6 months, requiring hospital admission and intravenous administration of hydrocortisone. At outpatient follow-up, she was taking hydrocortisone 15 mg in the morning and 10 mg at midday, and fludrocortisone 50 micrograms daily.

What is the most important next step in management to prevent further crises?
A . change to sustained-release hydrocortisone
B . increase dosage of hydrocortisone
C . measure plasma adrenocorticotropic hormone
D . measure plasma renin
E . measure post-dose 09.00 h cortisol

View Answer

Answer: D