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Does recovery of adrenal function occur in patients with autoimmune Addison’s disease?
Author(s) -
Smans Lisanne C. C. J.,
Zelissen Pierre M. J.
Publication year - 2011
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2010.03944.x
Subject(s) - medicine , endocrinology , mineralocorticoid , glucocorticoid , adrenal insufficiency , addison's disease , autoimmune disease , adrenocortical insufficiency , stimulation , adrenal function , disease , adrenocorticotropic hormone , cosyntropin , acth stimulation test , hormone
Summary Objective We earlier discovered partial recovery in a patient with autoimmune Addison’s disease. The aim of this study was to assess the occurrence of adrenocortical recovery in patients with autoimmune adrenalitis. Design Cross‐sectional study. Patients Twenty‐seven adult patients with autoimmune Addison’s disease on stable glucocorticoid and mineralocorticoid replacement therapy (RT) attending the Department of Endocrinology of a university teaching hospital were included in this study. Methods Adrenocortical function was assessed by performing an adrenocorticotrophic hormone (ACTH) (250 μg Synacthen) stimulation test (SST) after interruption of current glucocorticoid and mineralocorticoid RT. A normal adrenal response was defined as a serum cortisol concentration ≥500 n m 30 or 60 min after stimulation. Partial recovery was defined as a cortisol concentration ≥100 and ≤500 n m after stimulation. Results In 17 patients (63%), serum cortisol concentrations remained undetectable 30 and 60 min after the administration of ACTH. None of the remaining 10 participants had a normal response. Only one patient reached a cortisol concentration of 100 n m after 60 min, but this could not be confirmed during a second SST. Conclusions In this cross‐sectional study among 27 patients with autoimmune adrenalitis, no new cases of adrenocortical recovery were found.