Generalized Weakness

doi:10.1017/9781009500760.005

Chapter 5 - Generalized Weakness

Published online by Cambridge University Press: 24 April 2026

Alexandra Lambert and

Tori Beth L. Snoad

Edited by

Angela Bray Lindsay and

Monica Kathleen Wattana

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Angela Bray Lindsay: Affiliation:
Virginia Commonwealth University
Monica Kathleen Wattana: Affiliation:
University of Texas, MD Anderson Cancer Center

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Summary

1. Initial assessment and stabilization of airway patency, breathing, and circulation should be performed.

2. It is important to have a high index of suspicion for adrenal insufficiency (AI) in cancer patients with refractory hypotension. AI can occur as a result of adrenal suppression from chronic glucocorticoid treatment, or less commonly, from metastatic disease to both adrenal glands.

3. Consider obtaining other laboratory work to evaluate for concomitant electrolyte abnormalities.

4. Review patient’s medication lists whenever accessible to evaluate for chronic steroid use.

5. Treatment involves resuscitation of blood pressure acutely with IV hydrocortisone and intravenous fluids followed by admission to the hospital.

Keywords

Adrenal crisis corticosteroids refractory shock oncologic emergency adrenal insufficiency adrenal cortisol pituitary hypotension hormone deficiencies

Information

Type: Chapter
Information: Oncologic Emergency Medicine
Clinical Cases Illustrating Key Concepts
, pp. 18 - 20
DOI: https://doi.org/10.1017/9781009500760.005 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2026

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