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| __NOTOC__ | | __NOTOC__ |
| {{Adrenal insufficiency}} | | {{Secondary adrenal insufficiency}} |
| {{CMG}} | | {{CMG}} {{AE}} {{ADS}} |
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| {{PleaseHelp}}
| | ==Overview== |
| | There is insufficient evidence to recommend routine screening for secondary adrenal insufficiency. |
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| There is insufficient evidence to recommend routine screening for [disease/malignancy].
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| OR
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| According to the [guideline name], screening for [disease name] is not recommended.
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| OR
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| According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
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| ==Screening== | | ==Screening== |
| | | There is insufficient evidence to recommend routine screening for secondary adrenal insufficiency. |
| *There is insufficient evidence to recommend routine screening for [disease/malignancy].
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| OR
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| *According to the [guideline name], screening for [disease name] is not recommended.
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| OR
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| *According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with:
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| **[condition 1]
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| **[condition 2]
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| **[condition 3]
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| ----
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| ==Screening==
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| Although screening for Addison disease in the traditional sense is not routinely done, there are laboratory tests that can be undertaken if a diagnosis for Addison is suspected. For example, these include:
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| • Blood testing; measuring blood levels of sodium, potassium, cortisol and ACTH. A blood test can also measure antibodies associated with the condition.
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| • ACTH stimulation test; this test involves measuring the level of cortisol in the blood before and after an injection of synthetic ACTH.
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| • Insulin-induced hypoglycemia test; occasionally, this test is performed if pituitary disease is a possible cause of adrenal insufficiency (secondary adrenal insufficiency).
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| • Imaging tests; a computerized tomography (CT) scan of the abdomen to check the size of the adrenal glands and look for other abnormalities that may give insight to the cause of the adrenal insufficiency. An MRI scan of the pituitary gland may also be indicated.
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| It is important to note that some papers have found that adolescents with diabetes type 1 who experience recurrent unexplained hypoglycemia should be screened for Addison’s disease. [16] [17]
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| ==References== | | ==References== |
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| [[Category:Needs content]] | | [[Category:Needs content]] |
| [[Category:Needs overview]] | | [[Category:Needs overview]] |
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| 1. "hypopituitary". WebMD. 2006.
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| 2. http://www.endotext.org/adrenal/adrenal13/adrenal13.htm
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| 3. "Causes of secondary and tertiary adrenal insufficiency in adults". Retrieved 10 November 2016.
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| 4. Rogoff JM, Stewart GN. THE INFLUENCE OF ADRENAL EXTRACTS ON THE SURVIVAL PERIOD OF ADRENALECTOMIZED DOGS. Science. 1927 Oct 7;66(1710):327–328. [PubMed]
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| 5. Betterle C, Morlin L. Autoimmune Addison’s disease. In: Ghizzoni L, Cappa M, Chrousos G, Loche S, Maghnie M, eds. Pediatric Adrenal Diseases. Endocrine Development. Vol. 20. Padova, Italy: Karger Publishers; 2011: 161–172.
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| 6. Neary N, Nieman L. Adrenal insufficiency: etiology, diagnosis and treatment. Current Opinion in Endocrinology, Diabetes and Obesity. 2010;(3):217–223
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| 7. Arlt W, Allolio B. Adrenal insufficiency. Lancet. 2003 May 31. 361(9372):1881-93. [Medline].
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| 8. Besser GM, Thorner MO. Adrenal insufficiency. Clinical Endocrinology. St Louis, Mo: Mosby-Year Book; 1996. [CD-ROM]
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| 9. Purandare A, Godil MA, Prakash D, Parker R, Zerah M, Wilson TA. Spontaneous adrenal hemorrhage associated with transient antiphospholipid antibody in a child. Clin Pediatr (Phila). 2001 Jun. 40(6):347-50. [Medline].
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| 10. Olafsson AS, Sigurjonsdottir HA. INCREASING PREVALENCE OF ADDISON DISEASE: RESULTS FROM A NATIONWIDE STUDY. Endocr Pract. 2016 Jan. 22 (1):30-5. [Medline].
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| 11. Kyriazopoulou V. Glucocorticoid replacement therapy in patients with Addison's disease. Expert Opin Pharmacother. 2007 Apr. 8(6):725-9. [Medline].
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| 12. Bergthorsdottir R, Leonsson-Zachrisson M, Oden A, et al. Premature mortality in patients with Addison's disease: a population-based study. J Clin Endocrinol Metab. 2006 Dec. 91(12):4849-53. [Medline]. [Full Text]
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| 13. White K, Arlt W. Adrenal crisis in treated Addison's disease: a predictable but under-managed event. Eur J Endocrinol. 2010 Jan. 162(1):115-20. [Medline].
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| 14. Hemminki K, Li X, Sundquist J, et al. Subsequent autoimmune or related disease in asthma patients: clustering of diseases or medical care?. Ann Epidemiol. 2010 Mar. 20(3):217-22.
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| 15. Chantzichristos D, Persson A, Eliasson B, et al. Mortality in patients with diabetes mellitus and Addison's disease: a nationwide, matched, observational cohort study. Eur J Endocrinol. 2017 Jan. 176 (1):31-9. [Medline].
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| 16. Hardy K J, Burge M R, Boyle P J. et al A treatable cause of recurrent severe hypoglycaemia. Diabetes Care 199417722–724. [PubMed]
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| 17. Phornphutkul C, Boney C M, Gruppuso P A. A novel presentation of Addison disease: hypoglycemia unawareness in an adolescent with insulin‐dependent diabetes mellitus. J Pediatr 1998132882–884.[PubMed]
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