International Journal of General Medicine (Jun 2023)
Addison’s Disease: Diagnosis and Management Strategies
Abstract
Mara Carsote,1,2 Claudiu Nistor3,4 1Department of Endocrinology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; 2Department of Gonads and Infertility, “C.I. Parhon” National Institute of Endocrinology, Bucharest, Romania; 3Department 4 – Cardio -Thoracic Pathology, Thoracic Surgery II Discipline, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; 4Thoracic Surgery Department, “Dr. Carol Davila” Central Emergency University Military Hospital, Bucharest, RomaniaCorrespondence: Mara Carsote, Aviatorilor Ave, 34-38, Sector 1, Bucharest, 011683, Romania, Tel +40744 851 934, Email [email protected]: We aim to overview Addison’s disease (AD) with regard to current diagnosis and management. This is a narrative review of full-length articles published in English between January 2022 and December 2022 (including online ahead of print versions) in PubMed-indexed journals. We included original studies in living humans regardless of the level of statistical significance starting from the key search terms “Addison’s disease” or “primary adrenal insufficiency” in title or abstract. We excluded articles with secondary adrenal insufficiency. Briefly, 199 and 355 papers, respectively were identified; we manually checked each of them, excluded the duplicates, and then selected 129 based on their clinical relevance in order to address our 1-year analysis. We organized the data in different subsections covering all published aspects on the subject of AD. To our knowledge, this is the largest AD retrospective from 2022 on published data. A massive role of genetic diagnosis especially in pediatric cases is highlighted; the importance of both pediatric and adult awareness remains since unusual presentations continue to be described. COVID-19 infection is a strong player amid this third year of pandemic although we still not do have large cohorts in this particular matter as seen, for instance, in thyroid anomalies. In our opinion, the most important topic for research is immune checkpoint inhibitors, which cause a large panel of endocrine side effects, AD being one of them.Keywords: Addison disease, cortisol, primary adrenal insufficiency, synacthen, congenital adrenal hyperplasia, immune checkpoint inhibitor, COVID-19
