Does recovery of adrenal function occur in patients with autoimmune Addison's disease?

Clin Endocrinol (Oxf)

Department of Internal Medicine and Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands.

Published: April 2011

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 nm 30 or 60 min after stimulation. Partial recovery was defined as a cortisol concentration ≥100 and ≤500 nm 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 nm 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.

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http://dx.doi.org/10.1111/j.1365-2265.2010.03944.xDOI Listing

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