Natural history of adrenal steroidogenesis in autoimmune Addison's disease following diagnosis and treatment.

Napier, Catherine, Allinson, Kathleen, Gan, Earn H, Mitchell, Anna L, Gilligan, Lorna C, Taylor, Angela E, Arlt, Wiebke and Pearce, Simon H S (2020) Natural history of adrenal steroidogenesis in autoimmune Addison's disease following diagnosis and treatment. The Journal of clinical endocrinology and metabolism. ISSN 1945-7197. Full text available to UHB Open Athens account holders.

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Official URL: https://academic.oup.com/jcem/advance-article/doi/...

Abstract

CONTEXT

The natural history of adrenal function in autoimmune Addison's disease once diagnosed and treated has not been systematically studied, but several case reports of recovery from established adrenal failure suggest it may not be uniform.

OBJECTIVE

To ascertain steroidogenic function in autoimmune Addison's disease immediately following diagnosis and during prolonged treatment.

DESIGN

We studied peak serum cortisol in response to ACTH1-24 in 20 newly diagnosed autoimmune Addison's disease patients at first presentation and then again within a month. We also studied 37 patients with established Addison's disease (for between 7 months and 44 years) in a medication-free state, measuring peak serum cortisol responses to ACTH1-24 and the urine LC-MS steroid metabolome.

RESULTS

Adrenal steroidogenesis declined rapidly after steroid replacement treatment for newly diagnosed Addison's disease was started, with a peak serum cortisol falling from 138 ± 19nmol/l (SEM) at presentation to 63 ± 13nmol/L over 4 weeks (P<0.003).

CONCLUSION

Autoimmune Addison's disease is a heterogeneous condition, showing a rapid decline in adrenal steroidogenesis during the first few weeks following diagnosis, but low-level residual function in a minority of patients, which appears to persist for many years.

Item Type: Article
Additional Information: Full text available to UHB Open Athens account holders.
Subjects: WK Endocrine system. Endocrinology
Divisions: Ambulatory Care > Endocrinology
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Depositing User: Mr Philip O'Reilly
Date Deposited: 30 Apr 2020 13:32
Last Modified: 30 Apr 2020 13:32
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3019

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