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


METHODS
Cross-sectional study.


METHODS
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.
Department of Internal Medicine and Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands. l.c.c.j.smans@umcutrecht.nl
Lisanne C C J
LC
Smans
Pierre M J
PM
Zelissen
D000224:Addison Disease / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology*; D000311:Adrenal Glands / Q000187:drug effects* / Q000378:metabolism*; D000324:Adrenocorticotropic Hormone / Q000494:pharmacology; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D008901:Mineralocorticoids / Q000627:therapeutic use; D055815:Young Adult
D005938:Glucocorticoids; D008901:Mineralocorticoids; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone