Adrenal insufficiency natural history, complications and prognosis

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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

If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

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

• 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.

Complications

• Common complications of adrenal insufficiency include:
  • Increased risk of cardiovascular complications.
  • Sleep disturbance due to disruption of circadian rhythm.
  • 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 is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
• 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.
• The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
• [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.