Adrenal insufficiency from over-the-counter medicine as a cause of shock in rural area of Thailand: a study at Sisaket Provincial Hospital during October 2012--October 2013.

This retrospective study was carried out to estimate the prevalence of an adrenal crisis at a provincial hospital in Thailand over a period of 1 year, and also to explore the relationship between adrenal insufficiency and over-the-counter medicine (OTCM) ingestion. We recruited those patients admitted at Sisaket Hospital between October 2012 and October 2013 who were diagnosed with shock and adrenal insufficiency or adrenal crisis. Of 2,435 patients diagnosed with shock from all causes, 62 (2.55 %) were diagnosed with adrenal crisis, of whom 31 (50.0%) gave a history of OTCM ingestion. This study suggests adrenal crisis with shock is not that uncommon and that the use of OTCM may be the prime culprit.