ArticleThe Journal of clinical endocrinology and metabolism2020
Increased Infection Risk in Addison's Disease and Congenital Adrenal Hyperplasia.
Article in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.
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Who cites it
46 citing papers in PubMed, 63 citations in OpenAlex.
- Modified-Release Hydrocortisone in Congenital Adrenal Hyperplasia.The Journal of clinical endocrinology and metabolism · 2021Trial
- Residual Corticosteroid Production in Autoimmune Addison Disease.The Journal of clinical endocrinology and metabolism · 2020Trial
- Endocrine complications of COVID-19: diabetes, musculoskeletal, thyroid, pituitary, adrenal, and gonadal disorders.Journal of the Endocrine Society · 2026Review
- Clinical burden of classic congenital adrenal hyperplasia and glucocorticoid-related complications: a claims analysis.Journal of the Endocrine Society · 2026Article
- Systematic mapping of rare genetic disease studies using UK primary care electronic health records.European journal of human genetics : EJHG · 2026Review
- Article
- Long-term administration of hydrocortisone: down-regulating the level of cytokine and resulting in injuring testicular tissue of juvenile mice.BMC pharmacology & toxicology · 2025Article
- Clinical Course of COVID-19 in Children With Adrenal Insufficiency: Results From National Data.The Journal of clinical endocrinology and metabolism · 2025Article
- Current Challenges and Future Directions in the Assessment of Glucocorticoid Status.Endocrine reviews · 2024Review
- Infections and gender: clues for diagnosis of adrenal insufficiency-a case report and a review of the literature.Internal and emergency medicine · 2024Review
- Serological Evidence and Self-reported Outcomes in Patients with Adrenal Insufficiency during the First Waves of COVID-19 in North-East Italy.Endocrine, metabolic & immune disorders drug targets · 2024Article
- Course of COVID-19 infection in patients with congenital adrenal hyperplasia.Frontiers in endocrinology · 2024Article
- Review
- Impact of coronavirus disease 2019 on patients with primary adrenal insufficiency: a cross-sectional study.Endocrine connections · 2023Article
- Monitoring treatment in pediatric patients with 21-hydroxylase deficiency.Frontiers in endocrinology · 2023Review
- Major immunophenotypic abnormalities in patients with primary adrenal insufficiency of different etiology.Frontiers in immunology · 2023Article
- Editorial: Adrenal insufficiency: Diagnostic approaches, treatments and outcomes.Frontiers in endocrinology · 2023Article
- Psychosocial Impact of the COVID-19 Pandemic on Children with Congenital Adrenal Hyperplasia and Their Families.Turkish archives of pediatrics · 2022Article
- Susceptibility and characteristics of infections in patients with glucocorticoid excess or insufficiency: the ICARO tool.European journal of endocrinology · 2022Article
- Cell-Specific Immune Regulation by Glucocorticoids in Murine Models of Infection and Inflammation.Cells · 2022Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
contextMortality and infection-related hospital admissions are increased in patients with primary adrenal insufficiency (PAI). However, the risk of primary care-managed infections in patients with PAI is unknown.
objectiveTo estimate infection risk in PAI due to Addison's disease (AD) and congenital adrenal hyperplasia (CAH) in a primary care setting.
designRetrospective cohort study using UK data collected from 1995 to 2018.
main outcome measuresIncidence of lower respiratory tract infections (LRTIs), urinary tract infections (UTIs), gastrointestinal infections (GIIs), and prescription counts of antimicrobials in adult PAI patients compared to unexposed controls.
resultsA diagnosis of PAI was established in 1580 AD patients (mean age 51.7 years) and 602 CAH patients (mean age 35.4 years). All AD patients and 42% of CAH patients were prescribed glucocorticoids, most frequently hydrocortisone in AD (82%) and prednisolone in CAH (50%). AD and CAH patients exposed to glucocorticoids, but not CAH patients without glucocorticoid treatment, had a significantly increased risk of LRTIs (adjusted incidence rate ratio AD 2.11 [95% confidence interval (CI) 1.64-2.69], CAH 3.23 [95% CI 1.21-8.61]), UTIs (AD 1.51 [95% CI 1.29-1.77], CAH 2.20 [95% CI 1.43-3.34]), and GIIs (AD 3.80 [95% CI 2.99-4.84], CAH 1.93 [95% CI 1.06-3.52]). This was mirrored by increased prescription of antibiotics (AD 1.73 [95% CI 1.69-1.77], CAH 1.77 [95% CI 1.66-1.89]) and antifungals (AD 1.89 [95% CI 1.74-2.05], CAH 1.91 [95% CI 1.50-2.43]).
conclusionsThere is an increased risk of infections and antimicrobial use in PAI in the primary care setting at least partially linked to glucocorticoid treatment. Future studies will need to address whether more physiological glucocorticoid replacement modes could reduce this risk.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.