In autoimmune adrenal insufficiency, or Addison's disease (AD), the immune system attacks the adrenal cortex. As a result, the adrenal cells producing hormones such as cortisol and aldosterone are destroyed, leaving the body with insufficient levels to meet its needs. The common perception is that upon diagnosis of Addison's disease, basically all adrenal hormone production has ceased.
There have, however, been found a few individuals who preserve some residual secretion of cortisol even years after diagnosis. The objectives of this study is to find out how common it is, and to explore if residual function have impact on patient outcome. That is, do patients with and without residual function differ when it comes to quality of life, working ability, medication dosages, and risk of adrenal crisis?
Who can participate
Age range18 Years – 70 Years
SexALL
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Inclusion Criteria:
* Men and women with AAD, age 18-70 years old. This requires documented adrenal insufficiency and a positive test for 21-hydroxylase autoantibodies (biomarker for autoimmune cause) on at least one occasion.
* Provided written informed consent
* In case of concomitant endocrine/autoimmune diseases, the patients should be on stable adequate treatment at least the last 3 months prior to the study period.
* For Norwegian AD patients: enrolled in ROAS
* For Swedish AD patients: enrolled in the Swedish Addison registry
Exclusion Criteria:
* Antihypertensive treatment, with the exception of doxazosin, verapamil, and moxonidine.
* Active malignant disease, severe heart, kidney or liver failure.
* Diabetes mellitus type 1.
* Pregnancy or breast feeding.
* Pharmacological treatment with glucocorticoids (except their usual cortisone or hydrocortisone replacement therapy) or drugs that interfere with cortisol and catecholamine metabolism (antiepileptics, rifampicin, St. Johns wart).
* Use of other glucocorticoid replacement medication than cortisone acetate or hydrocortisone.
* Intake of grapefruit, grapefruit juice, or and liquorice juice the last week before or during the study period.
What they're measuring
1
The percentage of included patients with residual secretion of cortisol and aldosterone.