ArticleClinical endocrinology2012
Predicting the onset of Addison's disease: ACTH, renin, cortisol and 21-hydroxylase autoantibodies.
Article in Clinical endocrinology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 32 citations in OpenAlex.
- Autoimmune adrenal insufficiency in children: a hint for polyglandular syndrome type 2?Italian journal of pediatrics · 2023Article
- Pediatric Adrenal Insufficiency: Challenges and Solutions.Therapeutics and clinical risk management · 2022Review
- Adrenal cortex renewal in health and disease.Nature reviews. Endocrinology · 2021Review
- Epidemiology, pathogenesis, and diagnosis of Addison's disease in adults.Journal of endocrinological investigation · 2019Review
- Adrenal insufficiency - recognition and management.Clinical medicine (London, England) · 2017Review
- Cortisol Levels in Children With Diabetic Ketoacidosis Associated With New-Onset Type 1 Diabetes Mellitus.Clinical pediatrics · 2017Article
- Recurrent hypoglycaemia in type-1 diabetes mellitus may unravel the association with Addison's disease: a case report.BMC research notes · 2014Article
- Endocrine autoimmune diseases and female infertility.Nature reviews. Endocrinology · 2014Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
contextAutoantibodies to 21-hydroxylase (21OH-AA) precede onset of autoimmune Addison's disease (AD). Progression to AD can take months to years, and early detection of metabolic decompensation may prevent morbidity and mortality.
objectiveTo define optimal methods of predicting progression to overt AD (defined by subnormal peak cortisol response to Cosyntropin) in 21OH-AA+ individuals. DESIGN, SETTING AND
participantsIndividuals were screened for 21OH-AA at the Barbara Davis Center from 1993 to 2011. Subjects positive for 21OH-AA (n = 87) were tested, and the majority prospectively followed for the development of Addison's disease, including seven diagnosed with AD upon 21OH-AA discovery (discovered), seven who progressed to AD (progressors) and 73 nonprogressors. MAIN OUTCOME MEASURED: Plasma renin activity (PRA), ACTH, baseline cortisol, peak cortisol and 21OH-AA were measured at various time points relative to diagnosis of AD or last AD-free follow-up.
resultsCompared with nonprogressors, in the time period 2 months-2 years prior to the onset of AD, progressors were significantly more likely to have elevated ACTH (11-22 pM, P < 1E-4), with no significant differences in mean PRA (P = 0·07) or baseline cortisol (P = 0·08), and significant but less distinct differences seen with 21OH-AA levels (P < 1E-4) and poststimulation cortisol levels (P = 6E-3).
conclusionModerately elevated ACTH is a more useful early indicator of impending AD than 21OH-AA, PRA or peak cortisol, in the 2 months-2 years preceding the onset of AD.
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