Department of Internal Medicine and Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands.
Clin Endocrinol (Oxf). 2011 Apr;74(4):434-7. doi: 10.1111/j.1365-2265.2010.03944.x.
We earlier discovered partial recovery in a patient with autoimmune Addison's disease. The aim of this study was to assess the occurrence of adrenocortical recovery in patients with autoimmune adrenalitis.
Cross-sectional study.
Twenty-seven adult patients with autoimmune Addison's disease on stable glucocorticoid and mineralocorticoid replacement therapy (RT) attending the Department of Endocrinology of a university teaching hospital were included in this study.
Adrenocortical function was assessed by performing an adrenocorticotrophic hormone (ACTH) (250 μg Synacthen) stimulation test (SST) after interruption of current glucocorticoid and mineralocorticoid RT. A normal adrenal response was defined as a serum cortisol concentration ≥500 nm 30 or 60 min after stimulation. Partial recovery was defined as a cortisol concentration ≥100 and ≤500 nm after stimulation.
In 17 patients (63%), serum cortisol concentrations remained undetectable 30 and 60 min after the administration of ACTH. None of the remaining 10 participants had a normal response. Only one patient reached a cortisol concentration of 100 nm after 60 min, but this could not be confirmed during a second SST.
In this cross-sectional study among 27 patients with autoimmune adrenalitis, no new cases of adrenocortical recovery were found.
我们之前发现一例自身免疫性艾迪生病患者出现部分恢复。本研究旨在评估自身免疫性肾上腺炎患者是否存在肾上腺皮质恢复。
横断面研究。
27 例接受稳定糖皮质激素和盐皮质激素替代治疗（RT）的成人自身免疫性艾迪生病患者，来自一所大学教学医院的内分泌科。
在中断当前糖皮质激素和盐皮质激素 RT 后，通过进行促肾上腺皮质激素（ACTH）（250 μg Synacthen）刺激试验（SST）来评估肾上腺皮质功能。正常肾上腺反应定义为刺激后 30 或 60 分钟血清皮质醇浓度≥500nm。部分恢复定义为刺激后皮质醇浓度≥100nm 但≤500nm。
在 17 名患者（63%）中，ACTH 给药后 30 和 60 分钟血清皮质醇浓度仍无法检测到。其余 10 名参与者均无正常反应。只有一名患者在 60 分钟后皮质醇浓度达到 100nm，但在第二次 SST 中无法确认。
在这项自身免疫性肾上腺炎患者的横断面研究中，未发现新的肾上腺皮质恢复病例。
