Endocrinol Metab.  2017 Mar;32(1):83-89. 10.3803/EnM.2017.32.1.83.

Clinical Characteristics of Patients with Adrenal Insufficiency in a General Hospital

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. mdkmk@dsmc.or.kr

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.

Keyword

Adrenal insufficiency; Hypopituitarism; Population characteristics

MeSH Terms

Adrenal Insufficiency*
Adrenocorticotropic Hormone
Anorexia
Arthralgia
Cross-Sectional Studies
Diagnosis
Female
Fever
Hospitals, General*
Humans
Hydrocortisone
Hypopituitarism
Korea
Population Characteristics
Retrospective Studies
Steroids
Tertiary Care Centers
Adrenocorticotropic Hormone
Hydrocortisone
Steroids

Figure

  • Fig. 1 Flow chart showing the disposition of patients with adrenal insufficiency (AI) in the study. ACTH, adrenocorticotropic hormone.


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