Eighty‐six cases of Addison's disease

Kong, Marie‐France; Jeffcoate, William

doi:10.1111/j.1365-2265.1994.tb02790.x

Cited by 188 publications

(114 citation statements)

References 14 publications

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“…This prevalence appears lower than in the Scandinavian countries, Norway (144 per million) and Sweden (136 per million) (6, 7). It is also lower than most of the estimations for other European countries so far (3,4,5,6). As the latter figures are based on few data from very small populations, their validity is limited.…”

Section: European Journal Of Endocrinologymentioning

confidence: 47%

“…Epidemiological data in AD have been provided not only by either Scandinavian registries but also through investigator-initiated databases in the academic centers with a large referral area (3,4,5). We provide such data for the first time through a SHI.…”

Section: Discussionmentioning

confidence: 99%

“…For the European countries, the prevalence is estimated at 93-144 cases per million (1,2). These estimations, however, are based on few data from rather small populations -less than one million -in single European regions (3,4,5,6). Most convincing data come from the Scandinavian countries, where national patient registries exist (7,8).…”

Section: Introductionmentioning

confidence: 99%

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Increasing prevalence of Addison's disease in German females: health insurance data 2008–2012

Meyer

Neumann

Badenhoop

et al. 2014

European Journal of Endocrinology

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Objective: Our objective was to investigate the epidemiology of autoimmune Addison's disease (AD) in Germany. Design: Routine data were analyzed from the Statutory Health Insurance (SHI) database of the Techniker Krankenkasse (TK) for an observation period from 01/01/2008 to 31/12/2012. The TK is one of the largest German health care insurance providers covering more than 10% of the German population. Subjects and methods: Between 2008 and 2012, a total of 2477 diagnoses of primary adrenal failure were recorded in the SHI database. After exclusion of secondary, iatrogenic or other non-idiopathic forms and after adjustment for incomplete data sets, 1364 diagnoses of autoimmune-mediated AD remained. Results: The prevalence of AD in our cohort showed a steady increase from 82 per million in 2008 to 87 per million in 2012. On average, the prevalence rose about 1.8% per year, and due to a pronounced increase (2.7%) in females. The prevalence was lower in men (63-68 per million) than in women (96-108 per million). Autoimmune comorbidities were found in 46.5% of AD patients. Adrenal crises were documented with a frequency of 14-17/100 patient years. Conclusions: These data provide a first epidemiological profile of this rare and perilous endocrine disease in Germany. Although the prevalence of AD appears lower than in the Scandinavian countries, the increasing figures in females over the last 5 years warrant further investigations. Furthermore, adrenal crises pose a considerable burden. Hereby, we can show that health insurance data provide a valuable tool for epidemiological studies in the absence of national registries.

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Section: European Journal Of Endocrinologymentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

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Increasing prevalence of Addison's disease in German females: health insurance data 2008–2012

Meyer

Neumann

Badenhoop

et al. 2014

European Journal of Endocrinology

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“…Measurement of serum cortisol levels following synthetic ACTH injection forms the traditional "gold standard" for diagnosing AI (1)(2)(3). A decreased cortisol response is seen in both primary and chronic secondary AI (4), and diagnostic "cut-off" values of between 18-20 μg/dL are well-documented (2,3,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Aldosterone levels after ACTH stimulation can be helpful to distinguish between primary and secondary AI.…”

Section: Introductionmentioning

confidence: 99%

Use of steroid profiles in determining the cause of adrenal insufficiency

et al. 2007

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Hypothesis-A cortisol response to adrenocorticotropin injection is the standard test for diagnosing adrenal insufficiency. Multiple steroid hormones can now be accurately measured by tandem mass spectrometry in a single sample. The study objective was to determine whether a steroid profile, created by simultaneous measurement of ten steroid hormones by tandem mass spectrometry, would help determine the cause of adrenal insufficiency.Design-A ten-steroid profile was measured by tandem mass spectrometry during the performance of a standard high dose cortrosyn stimulation test. The steroids were measured at baseline, and 30 and 60 minutes following synthetic adrenocorticotropin injection. Adrenal insufficiency was defined as a peak cortisol level of less than 20 μg/dL. Testing was conducted in the General Clinical Research Center of a University Medical Center. Normal volunteers, patients suspected of having adrenal insufficiency, and patients with known adrenal insufficiency participated.Results-Our results showed that adrenal insufficiency of any cause was adequately diagnosed using the response of 11-deoxycortisol, dehydroepiandrosterone, or these analytes combined in a two-steroid profile. A three-steroid profile yielded a test with 100% accuracy for discriminating primary adrenal insufficiency from normal status. Primary adrenal insufficiency was well separated from secondary adrenal insufficiency using only a single aldosterone value. 11-deoxycortisol, dehydroepiandrosterone, and a two-steroid profile each provided fair discrimination between secondary adrenal insufficiency and normal status.Conclusions-We conclude that stimulated levels of aldosterone, 11-deoxycortisol, dehydroepiandrosterone, and a two-or three-steroid profile provided additional discrimination between states of adrenal sufficiency and insufficiency. It is proposed that a steroid profile measuring

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“…Adrenal insufficiency can be studied in two typesprimary and secondary. The female gender is dominant in both types; the incidence of primary adrenal insufficiency is high in the fortieth decade, while secondary insufficiency is more prevalent in the sixties (1,2). In developed countries, autoimmune diseases are the most common causes of primary adrenal insufficiency, while in developing countries, infectious agents, with tuberculosis (TB) being the most common continues to be the major causes.…”

Section: Introductionmentioning

confidence: 99%