Autoimmune Addison's disease

Publication date: Available online 30 January 2020Source: Best Practice &Research Clinical Endocrinology &MetabolismAuthor(s): Serena Saverino, Alberto FalorniPrimary adrenal insufficiency (PAI) occurs in 1/5000–1/7000 individuals in the general population. Autoimmune Addison's disease (AAD) is the major cause of PAI and is a major component of autoimmune polyendocrine syndrome type 1 (APS1) and type 2 (APS2). Presence of 21-hydroxylase autoantibodies (21OHAb) identifies subjects with ongoing clinical or pre-clinical adrenal autoimmunity. AAD requires life-long substitutive therapy with two-three daily doses of hydrocortisone (HC) (15–25 mg/day) or one daily dose of dual-release HC and with fludrocortisone (0.5–2.0 mg/day). The lowest possible HC dose must be identified according to clinical and biochemical parameters to minimize long-term complications that include osteoporosis and cardiovascular and metabolic alterations. Women with AAD have lower fertility and parity as compared to age-matched healthy controls. Patients must be educated to double-triple HC dose in the case of fever or infections and to switch to parenteral HC in the case of vomiting, diarrhoea or acute hypotension.
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research

Related Links:

Systemic sclerosis (SSc) is an autoimmune fibrotic disease whose pathogenesis is poorly understood and lacks effective therapies. We undertook quantitative analyses of T cell infiltrates in the skin of 35 untreated patients with early diffuse SSc and here show that CD4+ cytotoxic T cells and CD8+ T cells contribute prominently to these infiltrates. We also observed an accumulation of apoptotic cells in SSc tissues, suggesting that recurring cell death may contribute to tissue damage and remodeling in this fibrotic disease. HLA-DR–expressing endothelial cells were frequent targets of apoptosis in SSc, consistent with ...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
Roberto Pilloton Norovirus is one of the leading causes of gastroenteritis, acute vomiting, intense diarrhoea, acute pain in the stomach, high fever, headaches, and body pain. Conventional methods of detection gave us very promising results but had disadvantages such as low sensitivity, cost ineffectiveness, reduced specificity and selectivity, etc. Therefore, biosensors can be a viable alternative device which can overcome all setbacks associated with the conventional method. An electrochemical sensor based on oxidized graphitic carbon nitride (Ox-g-C3N4) modified electrochemical paper-based analytical device (ePAD) ...
Source: Sensors - Category: Biotechnology Authors: Tags: Article Source Type: research
AbstractFragility hip fractures and their associated morbidity and mortality pose a global healthcare problem. Several pharmaceutical products have been postulated to alter bone architecture and contribute to fragility hip fractures. We searched four electronic databases from inception to September 2017. Inclusion criteria were the following: (1) adult patients with fragility hip fractures, (2) full text in English, (3) minimum one-year follow-up, and (4) reporting of at least one risk factor. To minimize heterogeneity among the studies, we performed subgroup analyses. Whenever heterogeneity remained significant, we employ...
Source: Calcified Tissue International - Category: Orthopaedics Source Type: research
Conclusion: The new algorithm performed satisfactorily in identifying the risk of osteoporosis among the Malaysian population ≥50 years. Further validation studies are required before applying this algorithm for screening of osteoporosis in public.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Conclusions: Pazopanib monotherapy achieved a DCR of 90.3% in patients with locally advanced and/or metastatic neuroendocrine neoplasia, with an overall response rate comparable to other TKIs and mTOR inhibitors and a safety profile similar to that of drugs of the same class.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
AbstractSummaryThe prevalence of unknown vertebral fractures evaluated by systematic vertebral fracture assessment (VFA) was 21% in patients over 50  years of age who suffered from a recent low-trauma non-severe peripheral fracture. The outcome of VFA resulted in changes in the management of osteoporosis.IntroductionThe aim of this study was to evaluate the utility of VFA in detecting vertebral fractures (VFs) in patients over 50  years of age, who suffered from a recent low-trauma non-severe peripheral fracture.MethodsThis was an observational, single-center, cross-sectional study conducted in patients over 50 &...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
Autoimmune hemolytic anemias mediated by cold agglutinins can be divided into cold agglutinin disease (CAD), which is a well-defined clinicopathologic entity and a clonal lymphoproliferative disorder, and secondary cold agglutinin syndrome (CAS), in which a similar picture of cold-hemolytic anemia occurs secondary to another distinct clinical disease. Thus, the pathogenesis in CAD is quite different from that of polyclonal autoimmune diseases such as warm-antibody AIHA. In both CAD and CAS, hemolysis is mediated by the classical complement pathway and therefore can result in generation of anaphylotoxins, such as complement...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Predicting immunogenicity for biotherapies using patient and drug-related factors represents nowadays a challenging issue. With the growing ability to collect massive amount of data, machine learning algorithms can provide efficient predictive tools. From the bio-clinical data collected in the multi-cohort of autoimmune diseases treated with biotherapies from the ABIRISK consortium, we evaluated the predictive power of a custom-built random survival forest for predicting the occurrence of anti-drug antibodies. This procedure takes into account the existence of a population composed of immune-reactive and immune-tolerant su...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions. Multiple factors were associated with a significantly increased risk of VFX compared with NVFX. Understanding the risk factors unique to fragility VFX is a critical component for targeting “at-risk” patients and preventing future osteoporosis-related fractures and their consequences. Level of Evidence: 4
Source: Spine - Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
An artificial-intelligence tool outperforms radiologists in flagging fractures on imaging and may help get more patients at risk for osteoporosis on appropriate therapy to prevent another fracture.Reuters Health Information
Source: Medscape Orthopaedics Headlines - Category: Orthopaedics Tags: Diabetes & Endocrinology News Source Type: news
More News: Addison's Disease | Adrenal Insufficiency | Autoimmune Disease | Cardiology | Cardiovascular | Diarrhoea | Endocrinology | Heart | Hydrocortisone | Orthopaedics | Osteoporosis | Reproduction Medicine | Women