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Addison Disease: HELP
Articles from Adelaide
Based on 5 articles published since 2008
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These are the 5 published articles about Addison Disease that originated from Adelaide during 2008-2019.
 
+ Citations + Abstracts
1 Clinical Trial Reduction in daily hydrocortisone dose improves bone health in primary adrenal insufficiency. 2016

Schulz, Julia / Frey, Kathrin R / Cooper, Mark S / Zopf, Kathrin / Ventz, Manfred / Diederich, Sven / Quinkler, Marcus. ·Department of Clinical EndocrinologyCharité Campus Mitte, Charité University Medicine Berlin, Berlin, GermanyEndocrine and Diabetes UnitDepartment of Medicine I, University Hospital, University of Würzburg, Würzburg, GermanyAdrenal Steroid GroupANZAC Research Institute, Concord Repatriation General Hospital, Hospital Road, Concord Hospital, Concord, New South Wales 2139, AustraliaEndokrinologikumBerlin, GermanyEndocrinology in CharlottenburgStuttgarter Platz 1, 10627 Berlin, Germany. · Department of Clinical EndocrinologyCharité Campus Mitte, Charité University Medicine Berlin, Berlin, GermanyEndocrine and Diabetes UnitDepartment of Medicine I, University Hospital, University of Würzburg, Würzburg, GermanyAdrenal Steroid GroupANZAC Research Institute, Concord Repatriation General Hospital, Hospital Road, Concord Hospital, Concord, New South Wales 2139, AustraliaEndokrinologikumBerlin, GermanyEndocrinology in CharlottenburgStuttgarter Platz 1, 10627 Berlin, Germany Department of Clinical EndocrinologyCharité Campus Mitte, Charité University Medicine Berlin, Berlin, GermanyEndocrine and Diabetes UnitDepartment of Medicine I, University Hospital, University of Würzburg, Würzburg, GermanyAdrenal Steroid GroupANZAC Research Institute, Concord Repatriation General Hospital, Hospital Road, Concord Hospital, Concord, New South Wales 2139, AustraliaEndokrinologikumBerlin, GermanyEndocrinology in CharlottenburgStuttgarter Platz 1, 10627 Berlin, Germany marcus.quinkler@t-online.de. ·Eur J Endocrinol · Pubmed #26811406.

ABSTRACT: OBJECTIVE: Individuals with primary adrenal insufficiency (PAI) or congenital adrenal hyperplasia (CAH) receive life-long glucocorticoid (GC) replacement therapy. Current daily GC doses are still higher than the reported adrenal cortisol production rate. This GC excess could result in long-term morbidities such as osteoporosis. No prospective trials have investigated the long-term effect of GC dose changes in PAI and CAH patients. METHODS: This is a prospective and longitudinal study including 57 subjects with PAI (42 women) and 33 with CAH (21 women). Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry at baseline and after 2 years. Subjects were divided into three groups (similar baseline characteristics) depending on changes in daily hydrocortisone equivalent dose (group 1: unchanged 25.2±8.2  mg (mean±S.D., n=50); group 2: increased 18.7±10.3 to 25.9±12.0  mg (n=13); group 3: decreased 30.8±8.5 to 21.4±7.2  mg (n=27)). RESULTS: Subjects in group 1 showed normal lumbar and femoral Z-scores which were unchanged over time. Group 2 subjects showed a significant decrease in femoral neck Z-scores over time (-0.15±1.1 to -0.37±1.0 (P<0.05)), whereas group 3 subjects showed a significant increase in lumbar spine and hip Z-scores (L1-L4: -0.93±1.2 to -0.65±1.5 (P<0.05); total hip: -0.40±1.0 to -0.28±1.0 (P<0.05)). No changes in BMI over time were seen within any group. Reduction in GC dose did not increase the risk of adrenal crisis. CONCLUSION: This study demonstrates for the first time that cautious reduction in hydrocortisone equivalent doses leads to increases in BMD, whereas dose increments reduced BMD. These data emphasize the need for the lowest possible GC replacement dose in AI patients to maintain health and avoid long-term adverse effects.

2 Article Recurrent nocturnal hypoglycaemia as a cause of morning fatigue in treated Addison's disease--favourable response to dietary management: a case report. 2015

Petersen, Kristina S / Rushworth, R Louise / Clifton, Peter M / Torpy, David J. ·Dietitian, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5000, Australia. Kristina.Petersen@unisa.edu.au. · School of Medicine, Sydney, The University of Notre Dame, 60 Oxford St., Darlinghurst, NSW 2010, Australia. louise.rushworth@nd.edu.au. · School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5000, Australia. Peter.Clifton@unisa.edu.au. · Endocrine and Metabolic Unit, Royal Adelaide Hospital, University of Adelaide, North Terrace, Adelaide, SA 5000, Australia. David.Torpy@health.sa.gov.au. ·BMC Endocr Disord · Pubmed #26500000.

ABSTRACT: BACKGROUND: Addison's disease, or primary adrenal insufficiency, is often associated with reduced well-being and fatigue despite use of currently recommended adrenal hormone replacement. Hypoglycaemia is a known manifestation of glucocorticoid deficiency, but is generally considered rare in adults and not relevant to troubling ongoing symptoms in patients with Addison's disease. CASE PRESENTATION: A 43 year old woman with a three year history of Addison's disease complained of severe morning fatigue and headaches, despite standard glucocorticoid replacement therapy in the form of thrice daily hydrocortisone and mineralocorticoid replacement with fludrocortisone. Alternative glucocorticoid replacement regimens and the addition of dehydroepiandrosterone replacement therapy had no effect. Nocturnal hypoglycaemia was suspected and a 4-day continuous glucose monitor system (CGMS) revealed hypoglycaemia (interstitial glucose < 2.2 mmol/L) between 0200-0400 h on 3 of 4 days. The patient was counselled to take an evening snack designed to ensure slow absorption of ingested carbohydrates. Nocturnal hypoglycaemia was then absent on follow up CGMS assessment. The patient noted a marked symptomatic improvement in morning symptoms, but with persistent fatigue during the day. CONCLUSION: Currently, the best strategy for control of non-specific symptoms in treated Addison's disease is unknown, but it may be that investigation for hypoglycaemia and treatment, where necessary, could assist some sufferers to achieve improved wellbeing. A systematic study of this phenomenon in Addison's disease is required.

3 Article Continuous subcutaneous hydrocortisone infusion therapy in Addison's disease: a randomized, placebo-controlled clinical trial. 2014

Gagliardi, Lucia / Nenke, Marni A / Thynne, Tilenka R J / von der Borch, Jenny / Rankin, Wayne A / Henley, David E / Sorbello, Jane / Inder, Warrick J / Torpy, David J. ·Endocrine and Metabolic Unit (L.G., M.A.N., T.R.J.T., D.J.T.), Royal Adelaide Hospital, Adelaide 5000, Australia · School of Medicine (L.G., M.A.N., D.J.T.), University of Adelaide 5000, Australia · Diabetes Centre (J.v.d.B.), Royal Adelaide Hospital, Adelaide 5000, Australia · Department of Chemical Pathology (W.A.R.), SA Pathology, Adelaide 5000, Australia · Department of Endocrinology and Diabetes (D.E.H.), Sir Charles Gairdner Hospital, Perth 6009, Australia · School of Medicine and Pharmacology (D.E.H.), University of Western Australia, Perth 6009, Australia · Department of Diabetes and Endocrinology (J.S., W.J.I.), Princess Alexandra Hospital, Brisbane 4102, Australia · and School of Medicine (W.J.I.), University of Queensland, Brisbane 4072, Australia. ·J Clin Endocrinol Metab · Pubmed #25127090.

ABSTRACT: CONTEXT: Patients with Addison's disease (AD) report impaired subjective health status (SHS). Since cortisol exhibits a robust circadian cycle that entrains other biological clocks, impaired SHS may be due to the noncircadian cortisol profile achieved with conventional glucocorticoid replacement. Continuous subcutaneous hydrocortisone infusion (CSHI) reproduces a circadian cortisol profile, but its effects on SHS have not been objectively evaluated. OBJECTIVE: The aim of this study was to determine the effect of CSHI on SHS in AD. SETTING AND DESIGN: This was a multicentre, double-blind, placebo-controlled trial of CSHI vs oral glucocorticoid therapy. Participants received in random order 4 weeks of: CSHI and oral placebo, and subcutaneous placebo and oral hydrocortisone, separated by a 2-week washout period. SHS was assessed using the Short-Form 36 (SF-36), General Health Questionnaire (GHQ-28), Fatigue Scale (FS), Gastrointestinal Symptom Rating Scale (GSRS); and Addison's Quality of Life Questionnaire (AddiQoL). Participants were asked their (blinded) treatment preference. Twenty-four hour urine free cortisol (UFC) and diurnal salivary cortisol collections compared cortisol exposure during each treatment. RESULTS: Ten participants completed the study. Baseline SHS scores (mean ± SE) were consistent with mild impairment: SF-36 physical component summary 48.4 (± 2.4), mental component summary 53.3 (± 3.0); GHQ-28 18.1 (± 3.3); GSRS 3.7 (± 1.6), and AddiQoL 94.7 (± 3.7). FS was similar to other AD cohorts 13.5 (± 1.0) (P = 0.82). UFC between treatments was not different (P = 0.87). The salivary cortisol at 0800 h was higher during CSHI (P = 0.03), but not at any other time points measured. There was no difference between the treatments in the SHS assessments. Five participants preferred CSHI, four oral hydrocortisone, and one was uncertain. CONCLUSIONS: Biochemical measurements indicate similar cortisol exposure during each treatment period, although a more circadian pattern was evident during CSHI. CSHI does not improve SHS in AD with good baseline SHS. This casts some doubt on the potential benefit of circadian cortisol delivery on SHS in AD.

4 Article Rhabdomyolysis in acute primary adrenal insufficiency complicated by severe hyponatraemia. 2012

Lau, Su Yin / Yong, Tuck Yean. ·Department of Gastroenterology, Flinders Medical Centre, Australia. ·Intern Med · Pubmed #22975551.

ABSTRACT: Patients with acute adrenal insufficiency may have musculoskeletal symptoms including flexion contractures, myopathy and hyperkalaemic neuromyopathy. However, the association between rhabdomyolysis and acute adrenal insufficiency is extremely rare and has only been reported infrequently in the literature. Hyponatraemia is often present in association with acute adrenal insufficiency complicated by rhabdomyolysis. We herein report the case of a patient with acute primary adrenal insufficiency and severe hyponatraemia complicated by rhabdomyolysis and acute kidney injury.

5 Article 'Great tan but I feel awful'. Diagnosis: Autoimmune primary hypoadrenalism. 2008

Phillips, Patrick J / Weightman, Warren. ·Department of Endocrinology, The Queen Elizabeth Hospital, South Australia. patrick.phillips@nwahs.sa.gov.au ·Aust Fam Physician · Pubmed #18704214.

ABSTRACT: 'Everyone says I look great but I feel awful. I've lost weight, I feel sick all the time, I don't have any energy and I struggle just to get through the day'. Andrew is lean and tanned, but he has lost 8 kg since his last visit 3 months ago. He seems a bit flat in mood and listless in manner. He doesn't have a temperature, his blood pressure (BP) is 105/65, and examination of his chest and abdomen is normal. When the results of Andrew's tests come back the following day you are surprised to see abnormalities in his electrolytes.