ArticleThe Journal of clinical endocrinology and metabolism2020
Natural History of Adrenal Steroidogenesis in Autoimmune Addison's Disease Following Diagnosis and Treatment.
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 4 papers.
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Who cites it
4 citing papers in PubMed, 9 citations in OpenAlex.
- Aire Mutations and Autoimmune Diseases.Advances in experimental medicine and biology · 2025Review
- Plasma-Metanephrines in Patients with Autoimmune Addison's Disease with and without Residual Adrenocortical Function.Journal of clinical medicine · 2023Article
- Heterogeneous natural history of Addison's disease: mineralocorticoid deficiency may predominate.Endocrine connections · 2023Article
- Latent Adrenal Insufficiency: From Concept to Diagnosis.Frontiers in endocrinology · 2021Review
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
contextThe natural history of adrenal function in autoimmune Addison 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.
objectiveTo ascertain steroidogenic function in autoimmune Addison disease immediately following diagnosis and during prolonged treatment.
designWe studied peak serum cortisol in response to ACTH1-24 in 20 newly diagnosed autoimmune Addison disease patients at first presentation and then again within a month. We also studied 37 patients with established Addison 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.
resultsAdrenal steroidogenesis declined rapidly after steroid replacement treatment for newly diagnosed Addison disease was started, with a peak serum cortisol falling from 138 ± 19 nmol/L (SEM) at presentation to 63 ± 13 nmol/L over 4 weeks (P < 0.003).Six of 37 participants (16%) with established Addison disease had detectable serum cortisol and urine glucocorticoid and mineralocorticoid metabolites during repeat testing, indicating variable degrees of residual adrenal function.
conclusionAutoimmune Addison 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.
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