Adrenal insufficiency natural history, complications and prognosis: Difference between revisions

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{{Adrenal insufficiency}}
{{Adrenal insufficiency}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{Ayeesha}}


==Overview==
==Overview==
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Common complications of [[adrenal insufficiency]] include cardiovascular complications, disturbed sleep, reduced bone mineral density. Prognosis is generally excellent with replacement therapy.


OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==


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===Complications===
===Complications===
*Common complications of [disease name] include:
*Common complications of [[adrenal insufficiency]] include: <ref>{{cite web |url=https://www.amjmed.com/article/S0002-9343(15)00827-X/pdf |title=www.amjmed.com |format= |work= |accessdate=}}</ref>
**[Complication 1]
**Increased risk of cardiovascular complications.
**[Complication 2]
**Sleep disturbance due to disruption of [[circadian]] rhythm.
**[Complication 3]
**Decreased bone mineral density as a consequence of [[glucocorticoid]] therapy.
**[[Fertility]] and pregnancy complications: Reduced [[fertility]], increased risk of [[fetal growth restriction]], [[preterm birth]], [[cesarean]] delivery


===Prognosis===
===Prognosis===
*Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
*Prognosis is generally excellent with replacement therapy.
*Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
*Depending on the age of the diagnosis of [[adrenal insufficiency]] the prognosis may vary. If the patient is diagnosed before the age of 40, there is increased mortality.  
*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
*Mortality is increased in patients presenting with acute [[adrenal crisis]], infection, or associated with [[type 1 diabetes mellitus]] <ref name="ErichsenLøvås2009">{{cite journal|last1=Erichsen|first1=Martina M|last2=Løvås|first2=Kristian|last3=Fougner|first3=Kristian J|last4=Svartberg|first4=Johan|last5=Hauge|first5=Erik R|last6=Bollerslev|first6=Jens|last7=Berg|first7=Jens P|last8=Mella|first8=Bjarne|last9=Husebye|first9=Eystein S|title=Normal overall mortality rate in Addison's disease, but young patients are at risk of premature death|journal=European Journal of Endocrinology|volume=160|issue=2|year=2009|pages=233–237|issn=0804-4643|doi=10.1530/EJE-08-0550}}</ref>
*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.


==References==
==References==

Latest revision as of 04:30, 23 October 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayeesha Kattubadi, M.B.B.S[2]

Overview

Common complications of adrenal insufficiency include cardiovascular complications, disturbed sleep, reduced bone mineral density. Prognosis is generally excellent with replacement therapy.

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of adrenal insufficiency usually develop in the third to fifth decade of life, and start with symptoms such as fatigue, anorexia, weight loss, nausea, abdominal pain.
  • If left untreated, chronic adrenal insufficiency in the presence of precipitating factors can develop adrenal crisis presenting with acute hemodynamic compromise. [1]

Complications

Prognosis

  • Prognosis is generally excellent with replacement therapy.
  • Depending on the age of the diagnosis of adrenal insufficiency the prognosis may vary. If the patient is diagnosed before the age of 40, there is increased mortality.
  • Mortality is increased in patients presenting with acute adrenal crisis, infection, or associated with type 1 diabetes mellitus [3]

References

  1. Pazderska, Agnieszka; Pearce, Simon HS (2017). "Adrenal insufficiency – recognition and management". Clinical Medicine. 17 (3): 258–262. doi:10.7861/clinmedicine.17-3-258. ISSN 1470-2118.
  2. "www.amjmed.com".
  3. Erichsen, Martina M; Løvås, Kristian; Fougner, Kristian J; Svartberg, Johan; Hauge, Erik R; Bollerslev, Jens; Berg, Jens P; Mella, Bjarne; Husebye, Eystein S (2009). "Normal overall mortality rate in Addison's disease, but young patients are at risk of premature death". European Journal of Endocrinology. 160 (2): 233–237. doi:10.1530/EJE-08-0550. ISSN 0804-4643.

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