Adrenal crisis secondary to Covid-19 vaccination in patient with hypopituitarism; This is a literature report for the following literature source(s).  A 74-year-old male patient received BNT162b2 (BNT162B2), in Mar2021 as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "hypopituitarism" (ongoing); "significant for prolactinoma", start date: 1980 (unspecified if ongoing); "surgical resection", start date: 1980 (unspecified if ongoing); "hormone replacement therapy" (unspecified if ongoing), notes: subsequent hypopituitarism; "diabetes mellites type 2" (ongoing); "essential hypertension" (ongoing). The patient's concomitant medications were not reported. Past drug history included: Hydrocortisone for  hypopituitarism, notes: 10 mg twice daily; Levothyroxine for hypopituitarism, notes: 150 mcg daily; Desmopressin for hypopituitarism, notes: 0.1 mg half of tablet twice daily; Testosterone gel for hypopituitarism; Glargine for diabetes mellitus, notes: 20 units at bedtime; Insulin for diabetes mellitus, notes: diabetes mellitus; Glipizide for diabetes mellitus, notes: 2.5 mg twice daily; Sitagliptin for diabetes mellitus, notes: 100 mg daily. Vaccination history included: BNT162b2 (1st dose), administration date: 09Mar2021, for Covid-19 vaccination. The following information was reported: ADRENOCORTICAL INSUFFICIENCY ACUTE (hospitalization, intervention required, medically significant, life threatening), outcome "recovering", described as "Adrenal crisis secondary to Covid-19 vaccination in patient with hypopituitarism". The event "adrenal crisis secondary to covid-19 vaccination in patient with hypopituitarism" required emergency room visit. The patient underwent the following laboratory tests and procedures: Angiogram: negative, notes: for any acute central 61 nervous system (CNS) pathology; Bacterial test: negative; Blood alcohol: undetectable; Blood cortisol: 1.91 ug/dL; Blood glucose: 20 mg/dl; 143 mg/dl, notes: Workup in the ED; Blood pressure measurement: 145/84 mmHg; 107/71 mmHg, notes: subsequently decreased; Blood thyroid stimulating hormone: 0.006, notes: UIU/ml; Body temperature: 103.5 Fahrenheit, notes: Fever; Computerised tomogram head: negative, notes: for any acute central nervous system (CNS) pathology; CSF test: within normal limits; Full blood count: normal; Heart rate: 105, notes: Units:beats/minute; Metabolic function test: normal; physical exam: The patient was stuporous, notes: responsive only to painful stimuli with no focal deficit; Thyroxine free: 1.90 ng/dL; Urine analysis: negative; Viral test: negative. Therapeutic measures were taken as a result of adrenocortical insufficiency acute.  Clinical course included: Patient received his first dose of Covid-19 mRNA vaccine (BNT162b2) on 9Mar2021 and the second dose of the same vaccine 3 weeks after first dose at 1pm and within few hours experienced lethargy and confusion. Overnight patient developed fever which was treated with acetaminophen. The next day, patient was unable to converse, was more somnolent and sleeping for more than 24 hours. Patient did not have any recent sick contact, travel, change in medications or illicit drug use. During first day of hospital stay lumbar puncture was done and cerebrospinal fluid analysis was within normal limits with negative viral and bacterial cultures. Patient has been started on parenteral glucocorticoids and after 24h of intravenous hydrocortisone 50 mg every 6 hours patient had significant improvement in mental status, became more awake, oriented to himself, place and eventually time. Patient has been discharged on oral hydrocortisone with plan to tapper the dose down to his maintenance dose.  No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: As there is limited information in the case provided, the causal association between the events Adrenal Crisis and the suspect drug cannot be excluded. The case will be reassessed once new information is available. ,Linked Report(s) : US-PFIZER INC-202200640343 Same article/ drug/event and different patient: