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Clinical Characteristics of Patients with Adrenal Insufficiency in a General Hospital.

Clinical Characteristics of Patients with Adrenal Insufficiency in a General Hospital.
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Lee YY, Cho NH, Lee JW, Kim NK, Kim HS, Kim MK,


Lee YY, Cho NH, Lee JW, Kim NK, Kim HS, Kim MK, (click to view)

Lee YY, Cho NH, Lee JW, Kim NK, Kim HS, Kim MK,

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Endocrinology and metabolism (Seoul, Korea) 2017 02 28()
Abstract
BACKGROUND
Adrenal insufficiency (AI) is a life-threatening disorder caused by the deficiency of adrenal steroid hormones. This retrospective cross-sectional study investigated the characteristics of patients with AI in Korea.

METHODS
All consecutive patients with suspected AI who received care at a tertiary referral center in Korea in 2014 and underwent adrenocorticotropic hormone stimulation or insulin-tolerance testing were identified through a review of medical charts. Patients diagnosed with AI were enrolled. Their demographic, clinical, and treatment details were extracted.

RESULTS
Of 771 patients with suspected AI, 183 (23.7%) received a definitive diagnosis. The most common reason for testing was the presence of suspicious AI-related symptoms (30.0%), followed by a history of steroid medications (23.5%). Their mean age was 66.7 years, and females predominated (67.8%). The most common symptoms were general weakness, anorexia, arthralgia, and fever. Approximately half (53.6%) had a history of steroid use. Hydrocortisone was the most common treatment (71.6%), with most patients taking a 30 mg dose (44.2%). The most common dose frequency was twice a day (78.6%). Fourteen patients were treated for adrenal crisis (n=10, 5.5%) or an intercurrent illness (n=4, 2.2%).

CONCLUSION
AI may have been caused by steroid medication use in many of the patients included in this study. The detection of AI can be improved by careful history-taking and being alert to the possibility that a patient has used steroids.

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