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Clinical and immunological characteristics of Autoimmune Addison's disease: a nationwide Swedish multicenter study.

Artikel i vetenskaplig tidskrift
Författare Frida Dalin
Gabriel Nordling Eriksson
Per Dahlqvist
Åsa Hallgren
Jeanette Wahlberg
Olov Ekwall
Stefan Söderberg
Johan Rönnelid
Per Olcén
Ola Winqvist
Sergiu-Bogdan Catrina
Berit Kriström
Maria Laudius
Magnus Isaksson
Maria Halldin Stenlid
Jan Gustafsson
Gennet Gebre-Medhin
Sigridur Björnsdottir
Annika Janson
Anna-Karin Åkerman
Jan Åman
Karel Duchen
Ragnhildur Bergthorsdottir
Gudmundur Johannsson
Emma Lindskog
Mona Landin-Olsson
Maria Elfving
Erik Waldenström
Anna-Lena Hulting
Olle Kämpe
Sophie Bensing
Publicerad i The Journal of clinical endocrinology and metabolism
Volym 102
Nummer/häfte 2
Sidor 379-389
ISSN 1945-7197
Publiceringsår 2017
Publicerad vid Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning
Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Institutionen för kliniska vetenskaper, Avdelningen för pediatrik
Sidor 379-389
Språk en
Länkar dx.doi.org/10.1210/jc.2016-2522
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämneskategorier Klinisk medicin

Sammanfattning

Studies on clinical and immunological features of Autoimmune Addison's disease (AAD) are needed to understand the disease burden and increased mortality.To provide upgraded data on autoimmune comorbidities, replacement therapy, autoantibody profiles and cardiovascular risk factors.Cross sectional, population-based study. 660 AAD patients were included utilizing the Swedish Addison Registry (SAR) 2008-2014. When analyzing cardiovascular risk factors, 3,594 individuals from the population-based survey in Northern Sweden, MONICA (MONItoring of Trends and Determinants of CArdiovascular Disease), served as controls.Prevalence of autoimmune comorbidities and cardiovascular risk factors. Autoantibodies against 13 autoantigens were determined.Sixty percent of the SAR cohort consisted of females. Mean age at diagnosis was significantly higher for females than for males (36.8 vs. 31.1 years). The proportion of 21-hydroxylase autoantibody positive patients was 83% and 62% of patients had one or more associated autoimmune diseases, more frequently coexisting in females (p<0.0001). AAD patients had lower BMI (p<0.0001) and prevalence of hypertension (p=0.027) compared with controls. Conventional hydrocortisone tablets were used by 89% of patients; with the mean dose 28.1±8.5 mg/day. The mean hydrocortisone equivalent dose normalized to body surface was 14.8±4.4 mg/m(2)/day. Higher hydrocortisone equivalent dose was associated with higher incidence of hypertension (p=0.046).Careful monitoring of AAD patients is warranted to detect associated autoimmune diseases. Contemporary Swedish AAD patients do not have increased prevalence of overweight, hypertension, T2DM or hyperlipidemia. However, high glucocorticoid replacement doses may be a risk factor for hypertension.

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