Adrenal insufficiency, or “crisis,” is important to recognize because of its potentially life-threatening implications. Crisis occurs when the adrenal is prevented from producing normal amounts of its vital hormones. Symptoms and signs of adrenal crisis are varied and nonspecific. In infancy these include lethargy, vomiting, poor appetite and failure to thrive. Doctors may mistake these problems for formula intolerance or inadequate lactation, or alternatively, primary infectious or gastrointestinal disorders. In older children chronic fatigue, headache, gastrointestinal symptoms, salt-craving and excess skin pigmentation may be noted. Congenital adrenal hyperplasia is only one of many potential causes of adrenal crisis. Patients may undergo extensive evaluation before a diagnosis is made.